Abstract
Background and aimsClinical trials to determine the efficacy of radiotherapy (RT) in liver-confined but non-resectable Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) are scarce. We aimed to determine the benefit of RT in such tumors and investigated large HCC tumors.MethodsHCC data from the Korea Central Cancer Registry recorded from 2008 to 2010 were used. A total of 593 patients met our inclusion criteria; 67 were treated with RT while the remainder made up the non-RT group. Fifty-two RT recipients underwent combination treatments within 4 weeks after the first RT treatment, and were defined as the combination RT group. We performed propensity score matching (PSM) to compare the RT or combination RT groups with the non-RT group. The endpoint was overall survival (OS).ResultsMedian follow-up time for surviving patients was 48 months. After PSM, there was no difference in OS between the RT and non-RT groups or between the combination RT and non-RT groups. However, the combination RT group had a longer median survival time (MST) (10.7 vs. 6.9 months, respectively). Next, we conducted PSM between the combination RT and non-RT groups in patients with tumor sizes ≥10 cm; MST was significantly longer in the former group (10.1 vs. 5.4 months, respectively; bootstrap 95% confidence interval of the difference in MST: 0.2-11.8).ConclusionsAs a combined modality, RT is a plausible therapeutic option for liver-confined but non-resectable BCLC stage C large HCC patients.
Highlights
The Barcelona Clinic Liver Cancer (BCLC) staging system serves as a major treatment guideline [1]
We recently reported that hepatic arterial infusion concurrent chemoradiotherapy could improve survival for patients with locally advanced hepatocellular carcinoma (HCC) with good performance and normal liver function when comparing our institution’s database to that of the Korean Liver Cancer Study Group (KLCSG) nationwide multicenter HCC cohort treated between 2003 and 2005 [9]
We investigated the efficacy of RT, as well as combination therapy involving RT, in comparison to other treatments for liver-confined but non-resectable BCLC stage C HCC using a nationwide database constructed from a multi-center HCC cohort that was based on the Korea Central Cancer Registry
Summary
The Barcelona Clinic Liver Cancer (BCLC) staging system serves as a major treatment guideline [1]. Due to the aggressiveness and heterogeneity of BCLC stage C HCC, sub-classification and optimal therapeutic approaches require further investigation. The multimodal approach is a basic oncologic principle that has been successful in most types of locally advanced cancers. It often involves performing chemotherapy and radiotherapy, followed by surgery if possible [4,5,6]. Some researchers have examined whether the inclusion of RT in the multimodal approach enhances the survival outcome for BCLC stage C HCC [7,8,9], and the optimal criteria for local RT have been evaluated www.impactjournals.com/oncotarget [10, 11]. Clinical trials to determine the efficacy of radiotherapy (RT) in liver-confined but non-resectable Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) are scarce. We aimed to determine the benefit of RT in such tumors and investigated large HCC tumors
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