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Gamma knife radiosurgery versus transcatheter arterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus: a propensity score matching study.

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机构: [1]Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China [2]Clinical Research Institute, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China [3]Department of Body Gamma Knife Treatment Room, 363 Hospital, Chengdu 610041, China [4]Department of Oncology, 363 Hospital, Chengdu 610041, China [5]Department of Geriatric Cardiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu 610072, China [6]Department of Radiotherapy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China [7]Clinical Medical College, Southwest Medical University, Luzhou 646000, China [8]Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China [9]Department of Hepatobiliary, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China [10]Department of Oncology and Hematology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China [11]Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China [12]Clinical Skills Center, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China [13]Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou 646000, China [14]Academician (Expert) Workstation of Sichuan Province, Luzhou 646000, China [15]School of Basic Medical Sciences, Shandong University, Jinan 250011, China
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关键词: Gamma knife radiosurgery Radiotherapy Transcatheter arterial chemoembolization Hepatocellular carcinoma Primary liver cancer Portal vein tumor thrombus Propensity score matching Overall survival Cheng’s classification Advanced stage

摘要:
The optimal locoregional treatment for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) is unclear. This study aimed to investigate the efficacy of Gamma knife radiosurgery (GKR) versus transcatheter arterial chemoembolization (TACE) in HCC patients with PVTT.This retrospective study included 544 HCC patients with PVTT (GKR, 202; TACE, 342). Propensity score matching (PSM) analysis identified 171 matched pairs of patients. The primary endpoint was overall survival (OS).Before PSM, the GKR group exhibited longer median OS (mOS) than the TACE group (17.2 vs. 8.0 months, p < 0.001). We followed the Cheng's classification for PVTT. In the subgroup analysis, GKR was associated with significantly longer mOS for patients with PVTT II-IV (17.5 vs. 8.7 months, p < 0.001; 17.2 vs. 7.8 months, p = 0.001; 14.5 vs. 6.5 months, p = 0.001, respectively) and comparable OS for patients with PVTT I. After PSM, the GKR group had also a longer mOS than the TACE group (15.8 vs. 10.4 months, p < 0.001). In the subgroup analysis, the GKR group demonstrated superior mOS for patients with PVTT II-IV (all p < 0.05) and comparable OS for patients with PVTT I.GKR was associated better OS than TACE in HCC patients with PVTT, especially for patients with PVTT II-IV.The study was registered in the Chinese Clinical Trials Registry under the registration number ChiCTR2100051057.© 2022. The Author(s).

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大类 | 2 区 医学
小类 | 2 区 胃肠肝病学
最新[2023]版:
大类 | 2 区 医学
小类 | 3 区 胃肠肝病学
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Q1 GASTROENTEROLOGY & HEPATOLOGY
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Q1 GASTROENTEROLOGY & HEPATOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

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第一作者机构: [1]Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
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通讯机构: [1]Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China [13]Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou 646000, China [14]Academician (Expert) Workstation of Sichuan Province, Luzhou 646000, China [15]School of Basic Medical Sciences, Shandong University, Jinan 250011, China
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