Abstract
BackgroundThis study aimed to evaluate the effect of stereotactic ablative radiotherapy (SABR) after incomplete transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients.MethodsThe study enrolled 178 HCC patients initially treated with TACE between 2006 and 2011. Patients were included if they had Barcelona Clinic Liver Cancer stage 0 or A, ≤3 nodules with a total sum of longest diameter ≤10 cm, Child-Turcotte-Pugh score of ≤7, no major vessel invasion, and no extra-hepatic metastases.ResultsTwenty-four patients achieved a complete response to TACE (group 1). Among those with incomplete response, 47 patients received other curative treatments (group 2), 37 received SABR (group 3), and 70 received non-curative treatments (group 4). The 2–year overall survival (OS) rates for groups 1, 2, 3, and 4 were 88 %, 81 %, 73 %, and 54 %, respectively. The corresponding 5-year OS rates were 50 %, 58 %, 53 %, and 28 %, respectively.ConclusionsPatients treated with SABR after incomplete TACE had similar survival outcomes to those achieving complete response to TACE or receiving curative treatments. However, patients receiving non-curative treatments had significantly lower survival rates than the other groups. Therefore, if SABR was indicated at the initial diagnosis, it might be recommended after TACE failure.
Highlights
This study aimed to evaluate the effect of stereotactic ablative radiotherapy (SABR) after incomplete transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients
Baseline patient characteristics Of the 832 consecutive HCC patients treated with TACE, 178 met all eligibility criteria
Our enrollment suggests that among patients currently treated with TACE, approximately 21 % may be eligible for SABR
Summary
This study aimed to evaluate the effect of stereotactic ablative radiotherapy (SABR) after incomplete transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients. The primary treatment for hepatocellular carcinoma (HCC) is surgery, including hepatic resection and liver transplantation, which results in 5-year survival rates of 30–70 % [1]. Recent radiotherapeutic developments have gradually expanded the indications for external beam radiotherapy from palliative to curative with high doses of radiation safely delivered to the tumor while avoiding adverse effects to the liver function. Recent clinical data have demonstrated the feasibility of SABR for HCC treatment with high local control (LC) and overall survival (OS) rates and low treatment-related severe toxicities [13,14,15,16,17,18,19,20,21]
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