Kim Sungmin, Choi Youngmin, Kwak Dong-Won, Lee Hyung Sik, Hur Won-Joo, Baek Yang Hyun, Lee Sung Wook
Department of Radiation Oncology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
Radiat Oncol J. 2019 Sep;37(3):207-214. doi: 10.3857/roj.2019.00136. Epub 2019 Sep 30.
To identify the prognostic factors that could influence survival and to compare prognoses of the patients with the number of the risk factors that might assist in the adequate management of hepatocellular carcinoma (HCC) patients with bone metastases that showed a heterogeneous range of survival.
A total of 41 patients, treated with radiotherapy (RT) for bone metastases from HCC from 2014 to 2017, were enrolled retrospectively. Survival was determined by the Kaplan-Meier method from the start of the RT for metastatic bone lesions. Pre-RT clinical features were evaluated and their influences on survival were analyzed. The significant factors were considered to compare survivals according to the number of prognostic factors.
Median follow-up was 6.0 months (range, 0.5 to 47.0 months). The median overall survival was 6.5 months, and the 1-year and 2-year survival rates were 35.5% and 13.5%, respectively. Multivariate analysis revealed that the Child-Pugh class A group, alpha-fetoprotein increased more than 30 ng/mL, and HCC size of more than 5 cm were associated with worse overall survival. The median survivals in HCC with none, 1, 2, and 3 of the aforementioned risk factors were 19.5, 9.0, 2.5, and 1.0 months, respectively (p < 0.05).
Our results show that the overall survivals were significantly different according to the number of the risk factors among HCC patients with bone metastases who showed various lengths of survival.
确定可能影响生存的预后因素,并比较不同风险因素数量患者的预后情况,以协助对生存情况差异较大的骨转移肝细胞癌(HCC)患者进行适当管理。
回顾性纳入2014年至2017年期间接受放射治疗(RT)的41例HCC骨转移患者。从转移性骨病变开始放疗起,采用Kaplan-Meier法确定生存率。评估放疗前的临床特征并分析其对生存的影响。根据预后因素数量比较生存率,将有显著影响的因素纳入考虑。
中位随访时间为6.0个月(范围0.5至47.0个月)。中位总生存期为6.5个月,1年和2年生存率分别为35.5%和13.5%。多因素分析显示,Child-Pugh A级组、甲胎蛋白升高超过30 ng/mL以及HCC大小超过5 cm与较差的总生存期相关。上述风险因素数量分别为0、1、2和3的HCC患者的中位生存期分别为19.5、9.0、2.5和1.0个月(p < 0.05)。
我们的结果表明,在生存时间各异的骨转移HCC患者中,根据风险因素数量,总生存期存在显著差异。