Stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the treatment of hepatocellular carcinoma with portal vein invasion: a retrospective analysis
Abstract Background This study aimed to compare the clinical outcomes of stereotactic ablative radiotherapy (SABR) and conventionally fractionated radiotherapy (CFRT) in hepatocellular carcinoma (HCC) patients with portal vein invasion (PVI). Methods HCC patients with PVI treated with radiotherapy f...
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| Format: | Article |
| Language: | English |
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BMC
2019-10-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-019-1382-1 |
| _version_ | 1818558252906971136 |
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| author | Jen-Fu Yang Cheng-Hsiang Lo Meei-Shyuan Lee Chun-Shu Lin Yang-Hong Dai Po-Chien Shen Hsing-Lung Chao Wen-Yen Huang |
| author_facet | Jen-Fu Yang Cheng-Hsiang Lo Meei-Shyuan Lee Chun-Shu Lin Yang-Hong Dai Po-Chien Shen Hsing-Lung Chao Wen-Yen Huang |
| author_sort | Jen-Fu Yang |
| collection | DOAJ |
| description | Abstract Background This study aimed to compare the clinical outcomes of stereotactic ablative radiotherapy (SABR) and conventionally fractionated radiotherapy (CFRT) in hepatocellular carcinoma (HCC) patients with portal vein invasion (PVI). Methods HCC patients with PVI treated with radiotherapy from 2007 to 2016 were analysed. CFRT was administered at a median dose of 51.5 Gy (interquartile range, 45–54 Gy) with 1.8–3 Gy per fraction. SABR was administered at a median dose of 45 Gy (interquartile range, 40–48 Gy) with 6–12.5 Gy per fraction. Treatment efficacy, toxicity, and associated predictors were assessed. Results Among the 104 evaluable patients (45 in the SABR group and 59 in the CFRT group), the overall response rate (ORR, complete and partial response) was significantly higher in the SABR group than the CFRT group (62.2% vs. 33.8%, p = 0.003). The 1-year overall survival (OS) rate (34.9% vs. 15.3%, p = 0.012) and in-field progression-free survival (IFPS) rate (69.6% vs. 32.2%, p = 0.007) were also significantly higher in the SABR vs. CFRT group. All 3 rates remained higher in the SABR group after propensity score matching. Multivariable analysis identified SABR and a biologically effective dose ≥65 Gy as favourable predicators of OS. There was no difference between treatment groups in the incidence of radiation-induced liver disease or increase of Child-Pugh score ≥ 2 within 3 months of radiotherapy. Conclusions SABR was superior to CFRT in terms of ORR, OS, and IFPS. We suggest that SABR should be the preferred technique for HCC patients with PVI. |
| first_indexed | 2024-12-14T00:10:12Z |
| format | Article |
| id | doaj.art-eb67be1a37214278a9333c46d673b8c6 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-14T00:10:12Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-eb67be1a37214278a9333c46d673b8c62022-12-21T23:25:47ZengBMCRadiation Oncology1748-717X2019-10-0114111010.1186/s13014-019-1382-1Stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the treatment of hepatocellular carcinoma with portal vein invasion: a retrospective analysisJen-Fu Yang0Cheng-Hsiang Lo1Meei-Shyuan Lee2Chun-Shu Lin3Yang-Hong Dai4Po-Chien Shen5Hsing-Lung Chao6Wen-Yen Huang7Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical CenterDepartment of Radiation Oncology, Tri-Service General Hospital, National Defense Medical CenterSchool of Public Health, National Defense Medical CenterDepartment of Radiation Oncology, Tri-Service General Hospital, National Defense Medical CenterDepartment of Radiation Oncology, Tri-Service General Hospital, National Defense Medical CenterDepartment of Radiation Oncology, Tri-Service General Hospital, National Defense Medical CenterDepartment of Radiation Oncology, Tri-Service General Hospital, National Defense Medical CenterDepartment of Radiation Oncology, Tri-Service General Hospital, National Defense Medical CenterAbstract Background This study aimed to compare the clinical outcomes of stereotactic ablative radiotherapy (SABR) and conventionally fractionated radiotherapy (CFRT) in hepatocellular carcinoma (HCC) patients with portal vein invasion (PVI). Methods HCC patients with PVI treated with radiotherapy from 2007 to 2016 were analysed. CFRT was administered at a median dose of 51.5 Gy (interquartile range, 45–54 Gy) with 1.8–3 Gy per fraction. SABR was administered at a median dose of 45 Gy (interquartile range, 40–48 Gy) with 6–12.5 Gy per fraction. Treatment efficacy, toxicity, and associated predictors were assessed. Results Among the 104 evaluable patients (45 in the SABR group and 59 in the CFRT group), the overall response rate (ORR, complete and partial response) was significantly higher in the SABR group than the CFRT group (62.2% vs. 33.8%, p = 0.003). The 1-year overall survival (OS) rate (34.9% vs. 15.3%, p = 0.012) and in-field progression-free survival (IFPS) rate (69.6% vs. 32.2%, p = 0.007) were also significantly higher in the SABR vs. CFRT group. All 3 rates remained higher in the SABR group after propensity score matching. Multivariable analysis identified SABR and a biologically effective dose ≥65 Gy as favourable predicators of OS. There was no difference between treatment groups in the incidence of radiation-induced liver disease or increase of Child-Pugh score ≥ 2 within 3 months of radiotherapy. Conclusions SABR was superior to CFRT in terms of ORR, OS, and IFPS. We suggest that SABR should be the preferred technique for HCC patients with PVI.http://link.springer.com/article/10.1186/s13014-019-1382-1Hepatocellular carcinomaPortal vein invasionPortal vein thrombosisStereotactic ablative radiotherapyStereotactic body radiotherapyConventionally fractionated radiotherapy |
| spellingShingle | Jen-Fu Yang Cheng-Hsiang Lo Meei-Shyuan Lee Chun-Shu Lin Yang-Hong Dai Po-Chien Shen Hsing-Lung Chao Wen-Yen Huang Stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the treatment of hepatocellular carcinoma with portal vein invasion: a retrospective analysis Radiation Oncology Hepatocellular carcinoma Portal vein invasion Portal vein thrombosis Stereotactic ablative radiotherapy Stereotactic body radiotherapy Conventionally fractionated radiotherapy |
| title | Stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the treatment of hepatocellular carcinoma with portal vein invasion: a retrospective analysis |
| title_full | Stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the treatment of hepatocellular carcinoma with portal vein invasion: a retrospective analysis |
| title_fullStr | Stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the treatment of hepatocellular carcinoma with portal vein invasion: a retrospective analysis |
| title_full_unstemmed | Stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the treatment of hepatocellular carcinoma with portal vein invasion: a retrospective analysis |
| title_short | Stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the treatment of hepatocellular carcinoma with portal vein invasion: a retrospective analysis |
| title_sort | stereotactic ablative radiotherapy versus conventionally fractionated radiotherapy in the treatment of hepatocellular carcinoma with portal vein invasion a retrospective analysis |
| topic | Hepatocellular carcinoma Portal vein invasion Portal vein thrombosis Stereotactic ablative radiotherapy Stereotactic body radiotherapy Conventionally fractionated radiotherapy |
| url | http://link.springer.com/article/10.1186/s13014-019-1382-1 |
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