Lo Cheng-Hsiang, Liu Ming-Yueh, Lee Meei-Shyuan, Yang Jen-Fu, Jen Yee-Min, Lin Chun-Shu, Chao Hsing-Lung, Shen Po-Chien, Huang Wen-Yen
Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Int J Radiat Oncol Biol Phys. 2017 Sep 1;99(1):145-152. doi: 10.1016/j.ijrobp.2017.04.036. Epub 2017 May 3.
To evaluate the prognostic performance of the Child-Turcotte-Pugh (CTP) score and the albumin-bilirubin (ALBI) score in hepatocellular carcinoma (HCC) patients treated using stereotactic ablative radiation therapy (SABR).
This retrospective study evaluated the data of patients with HCC who underwent SABR between December 2007 and June 2015. We collected pretreatment CTP and ALBI scores and analyzed their correlation with survival and liver toxicity.
This study included 152 HCC patients: 78.3% of CTP class A and 21.7% of CTP class B. The median ALBI score was -2.49 (range, -3.67 to -0.84) with 39.5% of grade 1, 56.6% of grade 2, and 3.9% of grade 3. The CTP classification and ALBI grade were significantly associated with overall survival (P<.001). Albumin-bilirubin grade (1 vs 2) had a trend to stratify CTP class A patients into 2 risk groups of mortality (P=.061). Combined CTP class and ALBI score could predict development of radiation-induced liver disease (2.4% in CTP A-ALBI < -2.76, 15.1% in CTP A-ALBI ≥ -2.76, and 25.8% in CTP B).
Albumin-bilirubin score is a potential predictor for both survival and liver toxicity. Complementary use of CTP and ALBI score could predict the risk of post-SABR liver toxicity. Further prospective studies are necessary before use of the ALBI score can become part of daily practice.
评估Child-Turcotte-Pugh（CTP）评分和白蛋白-胆红素（ALBI）评分在接受立体定向消融放疗（SABR）治疗的肝细胞癌（HCC）患者中的预后性能。
这项回顾性研究评估了2007年12月至2015年6月期间接受SABR的HCC患者的数据。我们收集了治疗前的CTP和ALBI评分，并分析了它们与生存率和肝毒性的相关性。
本研究纳入了152例HCC患者：CTP A级占78.3%，CTP B级占21.7%。ALBI评分中位数为-2.49（范围为-3.67至-0.84），1级占39.5%，2级占56.6%，3级占3.9%。CTP分级和ALBI分级与总生存期显著相关（P<0.001）。白蛋白-胆红素分级（1级与2级）有将CTP A级患者分为两个死亡风险组的趋势（P=0.061）。联合CTP分级和ALBI评分可预测放射性肝病的发生（CTP A-ALBI < -2.76组为2.4%，CTP A-ALBI ≥ -2.76组为15.1%，CTP B组为25.8%）。
白蛋白-胆红素评分是生存和肝毒性的潜在预测指标。CTP评分和ALBI评分的互补使用可预测SABR后肝毒性风险。在ALBI评分成为日常实践的一部分之前，还需要进一步的前瞻性研究。
