English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Objectives: Large (≥10 cm) hepatocellular carcinomas (HCCs) carry a dismal prognosis and respond poorly to transarterial chemoembolisation (TACE). Combined TACE and hypofractionated image-guided radiotherapy (HIGRT) has emerged as a new treatment strategy. We evaluated its efficacy among these tumours and report the predictors of overall survival (OS). Methods: Data from 55 consecutive cases treated with preplanned combined TACE and HIGRT from 2007 to 2017 were evaluated from a prospectively collected database. Patients with advanced HCCs ≥10 cm, ineligible for curative intervention and with Child-Pugh scores ≤B7, received one dose of preplanned TACE 4 weeks prior to HIGRT. HIGRT doses were individualised according to the dose constraints of uninvolved liver and neighbouring organs at risk. OS was the primary endpoint. Results: In all, 55 patients with median tumour sizes of 15.3 cm were included. Tumour vascular thromboses and extrahepatic diseases were present in 25.5% and 32.7%, respectively. The median total equivalent dose in 2 Gy/fr (EQD2, α/β ratio = 10) was 32.7 Gy. The 2-year OS reached 24.9%. Clinical benefit rate was 83.6% with a 1-year local control rate of 57.4%. Multivariate analyses revealed alpha-fetoprotein (AFP) level (hazard ratio = 2.2, p = 0.025) and subsequent local treatment (hazard ratio = 0.2, p = 0.001) to be independent OS predictors. Responders undergoing subsequent curative resection achieved significantly better median OS than those without. Conclusion: Combined TACE and HIGRT achieved favourable survival outcomes among large HCCs. AFP level and subsequent local surgery were independent negative and positive OS predictors, respectively. Future studies are warranted.

hong kong journal of radiology

Prognostic Factors and Survival in Advanced Large Hepatocellular Carcinomas Treated with Combined Transarterial Chemoembolisation and Hypofractionated Image-guided Radiotherapy