Abstract
Background Recently, radiotherapy has been used in the treatment of hepatocellular carcinoma (HCC). However, there is no study analyzing the efficacy of radiotherapy in cases of advanced HCC. The objective of this investigation was to determine the efficacy of radiotherapy in patients with HCC invading distant organs. Methods The data of 2342 patients diagnosed between 2010 and 2015 with HCC invading distant organs were extracted from the SEER database. Propensity score matching (PSM) was used to reduce selection bias. Results Before PSM, the median overall survival (mOS) and median cancer-specific survival (mCSS) in the radiotherapy group (mOS = 5 months, 95% CI: 4.5–5.5; mCSS = 5 months, 95% CI: 4.4–5.6) were longer than those in the nonradiotherapy group (mOS = 3 months, 95% CI: 2.8–3.2; mCSS = 3 months, 95% CI: 2.8–3.2; both P < 0.001). After PSM, mOS in the radiotherapy group (5 months, 95% CI: 4.5–5.5) was longer than that in the nonradiotherapy group (3 months, 95% CI: 2.6–3.4; P < 0.001), and the mCSS in the radiotherapy group (5 months, 95% CI: 4.4–5.6) was longer than that in the nonradiotherapy group (3 months, 95% CI: 2.6–3.4; P < 0.001). Before PSM, the multivariate analysis showed that all-cause and cancer-specific mortality rates were higher in the nonradiotherapy group than in the radiotherapy group. The adjusted Cox regression analysis for subgroups showed that, in the nonradiotherapy group, patients with bone metastases and multiorgan metastases had a worse survival than those in the radiotherapy group. Conclusion HCC patients with metastases to distant organs obtain survival benefit from radiotherapy, particularly patients with bone metastases and multiorgan metastases.
Highlights
Hepatocellular carcinoma (HCC) is one of the most common cancers with one of the highest fatality rates [1]
After Propensity score matching (PSM), the median overall survival (mOS) (5 months, 95% CI: 4.4–5.6) and median cancer-specific survival (mCSS) (6 months, 95% CI: 5.2–6.8) of patients with bone metastases in the radiotherapy group were longer than the mOS (3 months, 95% CI: 2.5–3.5; P 0.002) and mCSS (3 months, 95% CI: 2.4–3.6; P < 0.001) in the nonradiotherapy group
The results demonstrated that the mOS was 5.1 months, which was similar to the mOS found in the current study
Summary
Hepatocellular carcinoma (HCC) is one of the most common cancers with one of the highest fatality rates [1]. In the last year a progress in early diagnosis of HCC has been reached, the changed scenario characterized by emerging etiologies such as metabolic causes of cirrhosis has led to a high rate of patients who receive HCC diagnosis in advance stages characterized by extrahepatic spread, as recently reported [11]. This changed scenario needs to enhance treatment strategies for advanced HCC, including radiotherapy. HCC patients with metastases to distant organs obtain survival benefit from radiotherapy, patients with bone metastases and multiorgan metastases
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