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The feasibility of combined transcatheter arterial chemoembolization and radiotherapy for advanced hepatocellular carcinoma
Author(s) -
Cho JuYeon,
Paik YongHan,
Park Hee Chul,
Yu Jeong Il,
Sohn Won,
Gwak GeumYoun,
Choi Moon Seok,
Lee Joon Hyeok,
Koh Kwang Cheol,
Paik Seung Woon,
Yoo Byung Chul
Publication year - 2014
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12445
Subject(s) - sorafenib , medicine , hepatocellular carcinoma , propensity score matching , transcatheter arterial chemoembolization , cohort , oncology , portal vein thrombosis , gastroenterology , liver cancer , clinical endpoint , thrombosis , randomized controlled trial
Background & Aims 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 ). Methods and Materials 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. Results 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, P < 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, P < 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, P < 0.001). Conclusions 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.