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Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus
BACKGROUND AND AIM: To investigate the value of changes in alpha-fetoprotein (AFP) levels for the prediction of radiologic response and survival outcomes in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) who received combined treatment of 3-dimensional conformal radio...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529136/ https://www.ncbi.nlm.nih.gov/pubmed/26252472 http://dx.doi.org/10.1371/journal.pone.0135298 |
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author | Jeong, Yuri Yoon, Sang Min Han, Seungbong Shim, Ju Hyun Kim, Kang Mo Lim, Young-Suk Lee, Han Chu Kim, So Yeon Park, Jin-hong Lee, Sang-wook Ahn, Seung Do Choi, Eun Kyung Kim, Jong Hoon |
author_facet | Jeong, Yuri Yoon, Sang Min Han, Seungbong Shim, Ju Hyun Kim, Kang Mo Lim, Young-Suk Lee, Han Chu Kim, So Yeon Park, Jin-hong Lee, Sang-wook Ahn, Seung Do Choi, Eun Kyung Kim, Jong Hoon |
author_sort | Jeong, Yuri |
collection | PubMed |
description | BACKGROUND AND AIM: To investigate the value of changes in alpha-fetoprotein (AFP) levels for the prediction of radiologic response and survival outcomes in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) who received combined treatment of 3-dimensional conformal radiotherapy (3D-CRT) and transarterial chemoembolization (TACE). METHODS: A database of 154 HCC patients with PVTT and elevated AFP levels (>20 ng/mL) treated with 3D-CRT and TACE as an initial treatment between August 2002 and August 2008 was retrospectively reviewed. AFP levels were determined 1 month after radiotherapy, and AFP response was defined as an AFP level reduction of >20% from the initial level. Radiologic response, overall survival (OS), and progression-free survival (PFS) rates were compared between AFP responders and non-responders. Propensity-score based matching analysis was performed to minimize the effect of potential confounding bias. RESULTS: The median follow-up period was 11.1 months (range, 3.1–82.7 months). In the propensity-score matching cohort (92 pairs), a best radiologic response of CR or PR occurred in more AFP responders than AFP non-responders (41.3% vs. 10.9%, p < 0.001). OS and PFS were also longer in AFP responders than in non-responders (median OS 13.2 months vs. 5.6 months, p < 0.001; median PFS 8.7 months vs. 3.5 months, p < 0.001). CONCLUSIONS: AFP response is a significant predictive factor for radiologic response. Furthermore, AFP response is significant for OS and PFS outcomes. AFP evaluation after combined radiotherapy and TACE appears to be a useful predictor of clinical outcomes in HCC patients with PVTT. |
format | Online Article Text |
id | pubmed-4529136 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-45291362015-08-12 Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus Jeong, Yuri Yoon, Sang Min Han, Seungbong Shim, Ju Hyun Kim, Kang Mo Lim, Young-Suk Lee, Han Chu Kim, So Yeon Park, Jin-hong Lee, Sang-wook Ahn, Seung Do Choi, Eun Kyung Kim, Jong Hoon PLoS One Research Article BACKGROUND AND AIM: To investigate the value of changes in alpha-fetoprotein (AFP) levels for the prediction of radiologic response and survival outcomes in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) who received combined treatment of 3-dimensional conformal radiotherapy (3D-CRT) and transarterial chemoembolization (TACE). METHODS: A database of 154 HCC patients with PVTT and elevated AFP levels (>20 ng/mL) treated with 3D-CRT and TACE as an initial treatment between August 2002 and August 2008 was retrospectively reviewed. AFP levels were determined 1 month after radiotherapy, and AFP response was defined as an AFP level reduction of >20% from the initial level. Radiologic response, overall survival (OS), and progression-free survival (PFS) rates were compared between AFP responders and non-responders. Propensity-score based matching analysis was performed to minimize the effect of potential confounding bias. RESULTS: The median follow-up period was 11.1 months (range, 3.1–82.7 months). In the propensity-score matching cohort (92 pairs), a best radiologic response of CR or PR occurred in more AFP responders than AFP non-responders (41.3% vs. 10.9%, p < 0.001). OS and PFS were also longer in AFP responders than in non-responders (median OS 13.2 months vs. 5.6 months, p < 0.001; median PFS 8.7 months vs. 3.5 months, p < 0.001). CONCLUSIONS: AFP response is a significant predictive factor for radiologic response. Furthermore, AFP response is significant for OS and PFS outcomes. AFP evaluation after combined radiotherapy and TACE appears to be a useful predictor of clinical outcomes in HCC patients with PVTT. Public Library of Science 2015-08-07 /pmc/articles/PMC4529136/ /pubmed/26252472 http://dx.doi.org/10.1371/journal.pone.0135298 Text en © 2015 Jeong et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Jeong, Yuri Yoon, Sang Min Han, Seungbong Shim, Ju Hyun Kim, Kang Mo Lim, Young-Suk Lee, Han Chu Kim, So Yeon Park, Jin-hong Lee, Sang-wook Ahn, Seung Do Choi, Eun Kyung Kim, Jong Hoon Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus |
title | Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus |
title_full | Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus |
title_fullStr | Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus |
title_full_unstemmed | Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus |
title_short | Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus |
title_sort | propensity score matching analysis of changes in alpha-fetoprotein levels after combined radiotherapy and transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529136/ https://www.ncbi.nlm.nih.gov/pubmed/26252472 http://dx.doi.org/10.1371/journal.pone.0135298 |
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