The feasibility of combined transcatheter arterial chemoembolization and radiotherapy for advanced hepatocellular carcinoma. (12th January 2014)

• Record Type: Journal Article
• Authors: Cho, Ju‐Yeon; Paik, Yong‐Han; Park, Hee Chul; Yu, Jeong Il; Sohn, Won; Gwak, Geum‐Youn; Choi, Moon Seok; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon; Yoo, Byung Chul
• Is Part Of: Liver international. Volume 34:Number 5(2014:Jun.)
• Page Start: 795
• Page End: 801
• Publication Date: 2014-01-12
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12445
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12445-abs-0001"> <title>Abstract</title> <sec id="liv12445-sec-0001" sec-type="section"> <title>Background & Aims</title> <p>Sorafenib is regarded as the standard treatment of care in Barcelona Clinic Liver Cancer (BCLC) stage C patients. However, the modest overall survival (OS) and disease control rate warrants for a better treatment modality. This study aimed to investigate the feasibility of combined transarterial chemoembolization and radiotherapy (TACE+RT) in comparison with sorafenib for advanced hepatocellular carcinoma (HCC).</p> </sec> <sec id="liv12445-sec-0002" sec-type="section"> <title>Methods and Materials</title> <p>From 2007 to 2011, a total of 116 patients with locally advanced HCC were retrospectively enrolled. Sixty‐seven patients treated with TACE+RT were compared with 49 patients treated with sorafenib. Propensity score matching generated a matched cohort composed of 27 patients from each group. OS was the primary endpoint for the analysis.</p> </sec> <sec id="liv12445-sec-0003" sec-type="section"> <title>Results</title> <p>At baseline, the sorafenib group had a tendency for a tumour size ≥10 cm, presence of lymph node metastasis and main portal vein tumour thrombosis compared to the TACE+RT group. The OS in the TACE+RT group was significantly longer compared to the sorafenib group (14.1 months vs. 3.3 months, <italic>P</italic> < 0.001). In the propensity score‐matched cohort, baseline characteristics did not differ between the two groups. The TACE+RT group showed prolonged OS compared to the sorafenib group (6.7 months vs. 3.1 months, <italic>P</italic> < 0.001). Multivariate analysis revealed that TACE+RT was the only independent prognostic factor associated with survival in the propensity score‐matched cohort (HR = 0.172, <italic>P</italic> < 0.001).</p> </sec> <sec id="liv12445-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The OS of TACE+RT was longer compared to sorafenib treatment in locally advanced HCC patients without distant metastasis. Further prospective studies are warranted to confirm these findings.</p> </sec> </abstract>