Cancer Res Treat.  2016 Jan;48(1):190-197. 10.4143/crt.2014.276.

Clinical Benefit of Hepatic Arterial Infusion Concurrent Chemoradiotherapy in Locally Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis

• Yoon HI
• Song KJ
• Lee IJ
• Kim DY
• Han KH
• Seong J

• KMID: 2152275
• DOI: http://doi.org/10.4143/crt.2014.276

Abstract

PURPOSE
The aim of this study was to evaluate whether hepatic arterial infusion concurrent chemoradiotherapy (CCRT) could improve overall survival (OS) in patients with locally advanced hepatocellular carcinoma (LAHCC).
MATERIALS AND METHODS
Two databases were reviewed from Yonsei Cancer Center (YCC) and Korean Liver Cancer Study Group (KLCSG) nationwide multi-center hepatocellular carcinoma (HCC) cohort. The CCRT group included 106 patients, with stage III-IV, Child-Pugh classification A, Eastern Cooperative Oncology Group performance status 0 or 1, who underwent definitive CCRT as the initial treatment at YCC. We used propensity score matching to adjust for seven clinical factors, including age, tumor size, TNM stage by the Liver Cancer Study Group of Japan, T stage, Barcelona Clinic Liver Cancer (BCLC) staging system, etiology of HCC, and portal vein invasion, which all differed significantly in the two databases. From the KLCSG cohort enrolled at 32 institutions, 106 patients for the non-CCRT group were defined.
RESULTS
After propensity score matching, all patient characteristics were balanced between the two groups. The CCRT group had better OS (median, 11.4) than the non-CCRT group (6.6 months, p=0.02). In multivariate analyses for all patients, CCRT (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.11 to 1.97; p=0.007), tumor size (HR, 1.08; 95% CI, 1.04 to 1.12; p < 0.001), and BCLC stage (HR, 0.54; 95% CI, 0.36 to 0.8; p=0.003) were independent prognostic factors for OS.
CONCLUSION
CCRT showed better OS for LAHCC patients. In LAHCC patients with a good performance and normal liver function, CCRT could be a feasible treatment option. All of these findings need to be validated in prospective clinical trials.

Keyword

Hepatocellular carcinoma; Radiotherapy; Propensity score

MeSH Terms

Carcinoma, Hepatocellular*
Chemoradiotherapy*
Classification
Cohort Studies
Humans
Japan
Liver
Liver Neoplasms
Multivariate Analysis
Portal Vein
Propensity Score*
Prospective Studies
Radiotherapy

Figure

• 

  Fig. 1. Kaplan-Meier curve of overall survival (OS) according to the two treatment groups. Kaplan-Meier curve depicted that concurrent chemoradiotherapy (CCRT) (median OS, 11.4 months; 2-year OS, 27.3%; 5-year OS, 10.4%) significantly improved OS compared to the non-CCRT group (median OS, 6.6 months; 2-year OS, 18.9%; 5-year OS, 8.5%; p=0.02).

• 

  Fig. 2. The difference in overall survival (OS) between the two treatment groups in each subgroup. CCRT, concurrent chemoradiotherapy; BCLC, Barcelona Clinic Liver Cancer.

Reference

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