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碳离子放疗与经肝动脉化疗栓塞术治疗单个肝细胞癌的疗效比较:一项倾向评分匹配研究。

A comparison of carbon ion radiotherapy and transarterial chemoembolization treatment outcomes for single hepatocellular carcinoma: a propensity score matching study.

机构信息

Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Syowa-machi, Maebashi, Gunma, 371-8511, Japan.

Gunma University Heavy Ion Medical Center, 3-39-22, Syowa-machi, Maebashi, Gunma, 371-8511, Japan.

出版信息

Radiat Oncol. 2019 Aug 2;14(1):137. doi: 10.1186/s13014-019-1347-4.

Abstract

BACKGROUND

We compared clinical outcomes of carbon ion radiotherapy and transarterial chemoembolization in the treatment of hepatocellular carcinoma.

METHODS

Data of 477 patients with hepatocellular carcinoma who had undergone carbon ion radiotherapy or transarterial chemoembolization between April 2007 and September 2016 were retrospectively reviewed. Treatment naïve patients with single HCC, who underwent carbon ion radiotherapy or transarterial chemoembolization as a primary treatment were included. Clinical outcomes of the treatments were compared after utilizing propensity score matching.

RESULTS

Of 124 patients who received carbon ion radiotherapy and 353 patients who received transarterial chemoembolization, 31 and 23 patients met our inclusion criteria, respectively. After utilizing propensity score matching, 17 matched pairs of patients from each treatment group were analyzed. The median follow-up durations after carbon ion radiotherapy and transarterial chemoembolization were 43 and 32 months, respectively. The 3-year overall survival, local control, and progression-free survival rates in the carbon ion radiotherapy versus transarterial chemoembolization groups were 88% versus 58% (p < 0.05), 80% versus 26% (p < 0.01), and 51% versus 15% (p < 0.05), respectively.

CONCLUSIONS

Carbon ion radiotherapy showed more favorable clinical outcomes than did transarterial chemoembolization for patients with single hepatocellular carcinoma after matching patient characteristics utilizing propensity score matching. Further studies with larger patient numbers are required to confirm our results.

TRIAL REGISTRATION

UMIN000036455 : date of registration 22 March 2019, retrospectively registered.

摘要

背景

我们比较了碳离子放疗和经动脉化疗栓塞治疗肝细胞癌的临床结果。

方法

回顾性分析了 2007 年 4 月至 2016 年 9 月期间接受碳离子放疗或经动脉化疗栓塞治疗的 477 例肝细胞癌患者的数据。纳入的患者均为接受碳离子放疗或经动脉化疗栓塞治疗的初治单发 HCC 患者。采用倾向评分匹配比较治疗后的临床结果。

结果

在接受碳离子放疗的 124 例患者和接受经动脉化疗栓塞的 353 例患者中,分别有 31 例和 23 例患者符合我们的纳入标准。采用倾向评分匹配后,对每个治疗组的 17 对匹配患者进行了分析。碳离子放疗和经动脉化疗栓塞后的中位随访时间分别为 43 个月和 32 个月。碳离子放疗组和经动脉化疗栓塞组的 3 年总生存率、局部控制率和无进展生存率分别为 88%比 58%(p<0.05)、80%比 26%(p<0.01)和 51%比 15%(p<0.05)。

结论

在匹配患者特征后,采用倾向评分匹配,与经动脉化疗栓塞相比,碳离子放疗为单发肝细胞癌患者带来了更有利的临床结果。需要进一步开展更大样本量的研究来证实我们的结果。

试验注册

UMIN000036455:注册日期 2019 年 3 月 22 日,回顾性注册。

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