Hepatic Resection Versus Stereotactic Body Radiation Therapy Plus Transhepatic Arterial Chemoembolization for Large Hepatocellular Carcinoma:A Propensity Score Analysis  

作　　者：Jing Sun Wen-Gang Li Quan Wang Wei-Ping He Hong-Bo Wang Ping Han Tao Zhang Ai-Min Zhang Yu-Ze Fan Ying-Zhe Sun Xue-Zhang Duan 

机构地区：[1]Radiation Oncology Department,Fifth Medical Center of Chinese PLA General Hospital,Beijing,China [2]Department of Hepatic Surgery,Fifth Medical Center of Chinese PLA General Hospital,Beijing,China

出　　处：《Journal of Clinical and Translational Hepatology》2021年第5期672-681,共10页临床与转化肝病杂志（英文版）

基　　金：This study protocol was supported by a grant from the Beijing Municipal Science and Technology Commission Fund(Z171100001017181).

摘　　要：Background and Aims:There are no comparative studies on the efficacy of hepatic resection(HR)and CyberKnife stereotactic body radiation therapy(CK-SBRT)plus transhepatic arterial chemotherapy embolization(TACE)in the treatment of large hepatocellular carcinoma(HCC).Therefore,this study aimed to compare the efficacy of HR and CKSBRT+TACE in large HCC.Methods:A total of one hundred and sixteen patients were selected from November 2011 to December 2016.Among them,50 were allocated to the CKSBRT+TACE group and 66 were allocated to the HR group.The Kaplan-Meier method was applied to calculate overall survival(OS)and progression-free survival(PFS)rates.Propensity score matching was performed to control for baseline differences between the groups.Results:Thirtysix paired patients were selected from the CK-SBRT+TACE and HR groups.After propensity score matching,the 1-,2-and 3-year OS rates were 83.3%,77.8%and 66.7%in the HR group and 80.6%,72.2%and 52.8%in the CKSBRT+TACE group,respectively.The 1-,2-and 3-year PFS rates were 71.6%,57.3%and 42.3%in the HR group and 66.1%,45.8%and 39.3%in the CK-SBRT+TACE group,respectively(OS:p=0.143;PFS:p=0.445).Both a high platelet count and low alpha-fetoprotein value were revealed as influencing factors in improving OS and PFS.Conclusions:CK-SBRT+TACE brought local effects that were similar to those of HR in HCC patients with a large and single lesion.Moreover,the liver injury occurrence rate was acceptable in both groups.

关 键 词：CYBERKNIFE Radiation-induced liver disease Survival rates Large hepatocellular carcinoma 

分 类 号：R73[医药卫生—肿瘤]