Stereotactic Body Radiation Therapy as an Alternative Treatment for Patients with Hepatocellular Carcinoma Compared to Sorafenib: A Propensity Score Analysis.
Hepatocellular carcinoma
Overall survival
Propensity score analysis
Sorafenib
Stereotactic body radiation therapy
Journal
Liver cancer
ISSN: 2235-1795
Titre abrégé: Liver Cancer
Pays: Switzerland
ID NLM: 101597993
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
13
03
2018
accepted:
20
05
2018
entrez:
12
10
2019
pubmed:
12
10
2019
medline:
12
10
2019
Statut:
ppublish
Résumé
Stereotactic body radiation therapy (SBRT) has emerged as a safe and effective treatment for patients with hepatocellular carcinoma (HCC), but its role in patients with advanced HCC is not yet defined. In this study, we aim to assess the efficacy and safety of SBRT in comparison to sorafenib treatment in patients with advanced HCC. We included 901 patients treated with sorafenib at six tertiary centers in Europe and Asia and 122 patients treated with SBRT from 13 centers in Germany and Switzerland. Medical records were reviewed including laboratory parameters, treatment characteristics and development of adverse events. Propensity score matching was performed to adjust for differences in baseline characteristics. The primary endpoint was overall survival (OS) and progression-free survival. Median OS of SBRT patients was 18.1 (10.3-25.9) months compared to 8.8 (8.2-9.5) in sorafenib patients. After adjusting for different baseline characteristics, the survival benefit for patients treated with SBRT was still preserved with a median OS of 17.0 (10.8-23.2) months compared to 9.6 (8.6-10.7) months in sorafenib patients. SBRT treatment of intrahepatic lesions in patients with extrahepatic metastases was also associated with improved OS compared to patients treated with sorafenib in the same setting (17.0 vs. 10.0 months, In this retrospective comparative study, SBRT showed superior efficacy in HCC patients compared to patients treated with sorafenib.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Stereotactic body radiation therapy (SBRT) has emerged as a safe and effective treatment for patients with hepatocellular carcinoma (HCC), but its role in patients with advanced HCC is not yet defined. In this study, we aim to assess the efficacy and safety of SBRT in comparison to sorafenib treatment in patients with advanced HCC.
METHODS
METHODS
We included 901 patients treated with sorafenib at six tertiary centers in Europe and Asia and 122 patients treated with SBRT from 13 centers in Germany and Switzerland. Medical records were reviewed including laboratory parameters, treatment characteristics and development of adverse events. Propensity score matching was performed to adjust for differences in baseline characteristics. The primary endpoint was overall survival (OS) and progression-free survival.
RESULTS
RESULTS
Median OS of SBRT patients was 18.1 (10.3-25.9) months compared to 8.8 (8.2-9.5) in sorafenib patients. After adjusting for different baseline characteristics, the survival benefit for patients treated with SBRT was still preserved with a median OS of 17.0 (10.8-23.2) months compared to 9.6 (8.6-10.7) months in sorafenib patients. SBRT treatment of intrahepatic lesions in patients with extrahepatic metastases was also associated with improved OS compared to patients treated with sorafenib in the same setting (17.0 vs. 10.0 months,
CONCLUSIONS
CONCLUSIONS
In this retrospective comparative study, SBRT showed superior efficacy in HCC patients compared to patients treated with sorafenib.
Identifiants
pubmed: 31602371
doi: 10.1159/000490260
pii: lic-0008-0281
pmc: PMC6738268
doi:
Types de publication
Journal Article
Langues
eng
Pagination
281-294Commentaires et corrections
Type : CommentIn
Type : ErratumIn
Informations de copyright
Copyright © 2018 by S. Karger AG, Basel.
Déclaration de conflit d'intérêts
D.B.: consulting Bayer Healthcare. L.R.: consulting Bayer Healthcare and Sirtex Medical.
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