| Zhao Yuting,Wang Hongzhi,Dong Dezuo,Zhu Xianggao,Gao Song,Zhu Xu,Wang Weihu.Long-term follow-up results of radiotherapy combined with transcatheter arterial chemoembolization and tyrosine kinase inhibitor in patients with hepatocellular carcinoma showing macrovascular invasion[J].Chinese Journal of Radiological Medicine and Protection,2022,42(8):577-583 |
| Long-term follow-up results of radiotherapy combined with transcatheter arterial chemoembolization and tyrosine kinase inhibitor in patients with hepatocellular carcinoma showing macrovascular invasion |
| Received:April 30, 2022 |
| DOI：10.3760/cma.j.cn112271-20220430-00184 |
| KeyWords:Hepatocellular carcinoma Macrovascular invasion Intensity-modulated radiotherapy Transcatheter arterial chemoembolization Tyrosine kinase inhibitor |
| FundProject:国家自然科学基金（82073333） |
| Author Name | Affiliation | E-mail | | Zhao Yuting | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China | | | Wang Hongzhi | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China | | | Dong Dezuo | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China | | | Zhu Xianggao | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China | | | Gao Song | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Interventional Therapy Department, Peking University Cancer Hospital and Institute, Beijing 100142, China | | | Zhu Xu | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Interventional Therapy Department, Peking University Cancer Hospital and Institute, Beijing 100142, China | | | Wang Weihu | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China | wangweihu88@163.com |
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| Abstract:: |
| Objective To assess the long-term follow-up results of intensity-modulated radiotherapy (IMRT) combined with transcatheter arterial chemoembolization (TACE) and tyrosine kinase inhibitor (TKI) in patients with hepatocellular carcinoma (HCC) showing macrovascular invasion (MVI).Methods A retrospective analysis was conducted for 63 patients with HCC showing MVI without distant metastasis treated in Peking University Cancer Hospital from October 2015 to October 2018. Among them 28 patients were treated with IMRT combined with TACE and sorafenib (Group A) and 35 patients were treated with IMRT combined with TACE (Group B). Propensity score matching (PSM) was applied to assess the progression-free survival (PFS) and the overall survival (OS) of both groups.Results The median follow-up time was 62 months. Before PSM, the median OS of group A and B were 19.0 months and 15.2 months (χ2=3.15, P=0.076), respectively, and the median PFS of groups A (10.7 months) was longer than that of group B (8.6 months;χ2=3.99, P=0.046). After PSM, the median OS of group A (30.6 months) was significantly longer than that of group B (15.2 months;χ2=5.34, P=0.023), and the PFS of groups A (12.5 months) was still longer than that of group B (8.3 months; χ2=4.79, P=0.026). In the whole group, 10 patients (15.9%) suffered from grade-3 hematologic toxicity, and seven patients (11.1%) experienced grade-3 hepatic toxicity. The incidence of skin reactions, hand-foot syndrome, and diarrhea in group A was higher than that in group B, but all these adverse events were grade 1-2. Moreover, no grade-4 adverse events, radiation-induced liver disease, and treatment-related mortality occurred in both groups.Conclusions As demonstrated by the long-term follow-up result, IMRT combined with TACE and TKI could improve both the PFS and the OS of patients with HCC showing MVI after PSM. |
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