Cargando…
Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib
Stereotactic body radiotherapy (SBRT) has shown promising results in the control of macroscopic vascular invasion in patients with hepatocellular carcinoma (HCC); however, its efficacy in comparison to sorafenib when combined with transarterial chemoembolization (TACE) remains to be determined. Betw...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6315557/ https://www.ncbi.nlm.nih.gov/pubmed/30558224 http://dx.doi.org/10.3390/cancers10120516 |
_version_ | 1783384323098935296 |
---|---|
author | Shen, Lujun Xi, Mian Zhao, Lei Zhang, Xuhui Wang, Xiuchen Huang, Zhimei Chen, Qifeng Zhang, Tianqi Shen, Jingxian Liu, Mengzhong Huang, Jinhua |
author_facet | Shen, Lujun Xi, Mian Zhao, Lei Zhang, Xuhui Wang, Xiuchen Huang, Zhimei Chen, Qifeng Zhang, Tianqi Shen, Jingxian Liu, Mengzhong Huang, Jinhua |
author_sort | Shen, Lujun |
collection | PubMed |
description | Stereotactic body radiotherapy (SBRT) has shown promising results in the control of macroscopic vascular invasion in patients with hepatocellular carcinoma (HCC); however, its efficacy in comparison to sorafenib when combined with transarterial chemoembolization (TACE) remains to be determined. Between 2009 and 2017, 77 HCC patients with macroscopic vascular invasion receiving TACE–SBRT or TACE–sorafenib combination therapies were enrolled. The best treatment responses, overall survival (OS), and progression-free survival (PFS) of the two treatment arms were compared. Of the patients enrolled, 26 patients (33.8%) received TACE–SBRT treatment, and 51 (66.2%) received TACE–sorafenib treatment. The patients in the TACE–SBRT group were more frequently classified as elder in age (p = 0.012), having recurrent disease (p = 0.026), and showing lower rates of multiple hepatic lesions (p = 0.005) than patients in TACE–sorafenib group. After propensity score matching (PSM), 26 pairs of well-matched HCC patients were selected; patients in the TACE–SBRT group showed better overall response rates in trend compared to those in the TACE–sorafenib group. The hazard ratio (HR) of OS to PFS for the TACE–SBRT approach and the TACE–sorafenib approach was 0.36 (95% CI, 0.17–0.75; p = 0.007) and 0.35 (95% CI, 0.20–0.62; p < 0.001), respectively. For HCC patients with macrovascular invasion, TACE plus SBRT could provide improved OS and PFS compared to TACE–sorafenib therapy. |
format | Online Article Text |
id | pubmed-6315557 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-63155572019-01-09 Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib Shen, Lujun Xi, Mian Zhao, Lei Zhang, Xuhui Wang, Xiuchen Huang, Zhimei Chen, Qifeng Zhang, Tianqi Shen, Jingxian Liu, Mengzhong Huang, Jinhua Cancers (Basel) Article Stereotactic body radiotherapy (SBRT) has shown promising results in the control of macroscopic vascular invasion in patients with hepatocellular carcinoma (HCC); however, its efficacy in comparison to sorafenib when combined with transarterial chemoembolization (TACE) remains to be determined. Between 2009 and 2017, 77 HCC patients with macroscopic vascular invasion receiving TACE–SBRT or TACE–sorafenib combination therapies were enrolled. The best treatment responses, overall survival (OS), and progression-free survival (PFS) of the two treatment arms were compared. Of the patients enrolled, 26 patients (33.8%) received TACE–SBRT treatment, and 51 (66.2%) received TACE–sorafenib treatment. The patients in the TACE–SBRT group were more frequently classified as elder in age (p = 0.012), having recurrent disease (p = 0.026), and showing lower rates of multiple hepatic lesions (p = 0.005) than patients in TACE–sorafenib group. After propensity score matching (PSM), 26 pairs of well-matched HCC patients were selected; patients in the TACE–SBRT group showed better overall response rates in trend compared to those in the TACE–sorafenib group. The hazard ratio (HR) of OS to PFS for the TACE–SBRT approach and the TACE–sorafenib approach was 0.36 (95% CI, 0.17–0.75; p = 0.007) and 0.35 (95% CI, 0.20–0.62; p < 0.001), respectively. For HCC patients with macrovascular invasion, TACE plus SBRT could provide improved OS and PFS compared to TACE–sorafenib therapy. MDPI 2018-12-14 /pmc/articles/PMC6315557/ /pubmed/30558224 http://dx.doi.org/10.3390/cancers10120516 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Shen, Lujun Xi, Mian Zhao, Lei Zhang, Xuhui Wang, Xiuchen Huang, Zhimei Chen, Qifeng Zhang, Tianqi Shen, Jingxian Liu, Mengzhong Huang, Jinhua Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib |
title | Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib |
title_full | Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib |
title_fullStr | Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib |
title_full_unstemmed | Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib |
title_short | Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib |
title_sort | combination therapy after tace for hepatocellular carcinoma with macroscopic vascular invasion: stereotactic body radiotherapy versus sorafenib |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6315557/ https://www.ncbi.nlm.nih.gov/pubmed/30558224 http://dx.doi.org/10.3390/cancers10120516 |
work_keys_str_mv | AT shenlujun combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT ximian combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT zhaolei combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT zhangxuhui combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT wangxiuchen combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT huangzhimei combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT chenqifeng combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT zhangtianqi combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT shenjingxian combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT liumengzhong combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib AT huangjinhua combinationtherapyaftertaceforhepatocellularcarcinomawithmacroscopicvascularinvasionstereotacticbodyradiotherapyversussorafenib |