Abstract
BackgroundAs stereotactic body radiation therapy (SBRT) has shown to be effective and safe in patients with hepatocellular carcinoma (HCC), the aim of our propensity score matched analysis was to evaluate the efficacy of SBRT in comparison to transarterial chemoembolization (TACE) in intermediate and advanced HCC.MethodsPatients treated with TACE (n = 367) and patients allocated to SBRT (n = 35) were enrolled in this study. Propensity score matching was performed to adjust for differences in baseline and tumor characteristics of TACE and SBRT patients. Local tumor control (LC) 1 year after treatment, overall survival (OS) and 1-year mortality were assessed.ResultsPatients treated with SBRT have received more prior HCC treatments compared to TACE patients. The LC 1 year after treatment in the unmatched cohort was 74.4% for TACE patients compared to 84.8% in the SBRT group. Patients treated with TACE showed significantly improved OS (17.0 months vs. 9.0 months, p = 0.016). After propensity score matching, the LC in the TACE (n = 70) and SBRT (n = 35) group was comparable (82.9% vs. 84.8%, p = 0.805) and OS did not differ significantly in both groups.ConclusionsSBRT after prior HCC therapy in selected patients shows comparable LC at 1 year, OS and 1-year mortality compared to patients treated with TACE.
Highlights
As stereotactic body radiation therapy (SBRT) has shown to be effective and safe in patients with hepatocellular carcinoma (HCC), the aim of our propensity score matched analysis was to evaluate the efficacy of SBRT in comparison to transarterial chemoembolization (TACE) in intermediate and advanced HCC
These reports have shown that SBRT is a feasible and well-tolerated treatment option for patients with HCC, there is no consensus in which setting SBRT should be used
We summarized the intrahepatic lesions in oligonodular and in multifocal HCC
Summary
As stereotactic body radiation therapy (SBRT) has shown to be effective and safe in patients with hepatocellular carcinoma (HCC), the aim of our propensity score matched analysis was to evaluate the efficacy of SBRT in comparison to transarterial chemoembolization (TACE) in intermediate and advanced HCC. It has been reported that SBRT can achieve high rates of local tumor control with acceptable toxicity in patients with HCC, in carefully selected patients with impaired liver function [6, 9]. These reports have shown that SBRT is a feasible and well-tolerated treatment option for patients with HCC, there is no consensus in which setting SBRT should be used. In order to analyze this important clinical issue, we performed a single-center, retrospective analysis by using propensity score matching focusing on local tumor control, overall survival (OS) and 1-year-mortality
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