肝细胞癌经动脉化疗栓塞后立体定向放射治疗的长期生存和预后因素

IF 1.5 Q4 ONCOLOGY
Cancer reports Pub Date : 2025-05-08 DOI:10.1002/cnr2.70212
Hoang Dong Duc, Mai Binh Thanh, Mai Bang Hong, Nguyen Thinh Tien, Nguyen Thai Van, Bui Bieu Quang, Nguyen Chau Dinh, Thai Ky Doan
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引用次数: 0

摘要

背景/目的本研究详细分析了立体定向体放疗(SBRT)和经动脉化疗栓塞(TACE)治疗肝癌患者的长期生存和影响预后的关键因素。我们的研究结果为TACE和SBRT联合治疗肝癌大肝肿瘤的潜力提供了保证。方法对2018年12月至2024年6月在108军区中心医院收治的42例中期肝细胞癌患者进行前瞻性研究。在单次TACE治疗后,每个患者在1个月后接受SBRT治疗。SBRT的剂量范围为27.5至48 Gy,分3-5次给药。采用Kaplan-Meier法进行患者生存分析,同时检查影响生存的预后因素,包括log-rank检验和Cox比例风险回归分析。结果42例患者中,男性占83.3%,肿瘤≥5 cm者34例,占81.0%。中位随访时间为32.2个月(4.5-65.1个月)。中位总生存期(OS)为32.6个月,1年、3年和5年的OS分别为73.8%、24.5%和19.6%。此外,中位无进展生存期(PFS)为16.6个月,相应的1年和3年PFS率分别为71.4%和19.0%。与OS和PFS改善相关的因素包括AFP水平和基于修订RECIST标准的治疗反应。此外,多变量分析确定患者年龄、EQD2和BED10是更好的生存结果的重要预测因素。结论本研究提供了支持TACE联合SBRT作为HCC大肝肿瘤患者治疗策略的有效性和安全性的证据,为HCC治疗的未来注入了信心。阳性预后因素包括患者年龄、EQD2和BED10。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Long-Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma

Long-Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma

Background/Aims

This study presents a detailed analysis of long-term survival and critical factors influencing the outcomes of hepatocellular carcinoma patients treated with stereotactic body radiotherapy (SBRT) and transarterial chemoembolization (TACE). Our findings provide reassurance about the potential of the combination of TACE and SBRT as an effective treatment strategy for patients with large liver tumors due to HCC.

Methods

A prospective study was conducted on 42 patients with intermediate-stage hepatocellular carcinoma (HCC) at 108 Military Central Hospital between December 2018 and June 2024. Following a single session of TACE, each patient underwent SBRT 1 month later. The SBRT dose ranged from 27.5 to 48 Gy, delivered in 3–5 fractions. The patient survival analysis was conducted using the Kaplan–Meier method while examining prognostic factors influencing survival, which involved log-rank tests and Cox proportional hazards regression analysis.

Results

Among the 42 patients (83.3% male), 34 patients (81.0%) had tumors measuring ≥ 5 cm. The median follow-up period was 32.2 months (4.5–65.1 months). The median overall survival (OS) was 32.6 months, with the respective 1-, 3-, and 5-year OS rates reported as 73.8%, 24.5%, and 19.6%. Furthermore, the median progression-free survival (PFS) was 16.6 months, with corresponding 1- and 3-year PFS rates of 71.4% and 19.0%. Factors linked to improved OS and PFS included AFP levels and treatment response based on Modified RECIST criteria. Additionally, multivariate analysis identified patient age, EQD2, and BED10 as significant predictors of better survival outcomes.

Conclusions

Our study provides evidence supporting the effectiveness and safety of combining TACE and SBRT as a treatment strategy for patients with large liver tumors due to HCC, instilling confidence in the future of HCC treatment. Positive prognostic factors included patient age, EQD2, and BED10.

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来源期刊
Cancer reports
Cancer reports Medicine-Oncology
CiteScore
2.70
自引率
5.90%
发文量
160
审稿时长
17 weeks
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