Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan.
Ultrasound Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
PLoS One. 2021 Jan 5;16(1):e0245076. doi: 10.1371/journal.pone.0245076. eCollection 2021.
To evaluate the safety and efficacy of the administration of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) in the short term to the same patients in Barcelona Clinical Liver Cancer (BCLC) stages 0-B1.
From April 2014 to June 2019, we retrospectively reviewed BCLC stage 0-B1 patients with fresh hepatocellular carcinoma (HCC) lesions that were repeatedly treated by RFA (control group, n = 72), and by RFA and subsequent SBRT (case group, n = 26). Propensity score matching (PSM) was performed to reduce the selection bias between two groups. Recurrence, survival, Child-Pugh scores and short-term side effects (fever, bleeding, skin change, abdominal pain and fatigue) were recorded and analyzed.
After PSM, 21 patients remained in each group. Seventeen and 20 patients in the case and control groups experienced recurrence. For these patients, the median times to progression and follow-up were 10.7 and 35.8 months, respectively. After PSM, the 1-year progression-free survival rate in case and control groups were 66.7% and 52.4%, respectively (P = 0.313). The inter-group overall survival (OS) was comparable (3 and 5-year OS rates in case groups were 87.3% and 74.8%, while rates in control groups were 73.7% and 46.3%, respectively; P = 0.090). The short-term side effects were mild, and the incidence showed no inter-group difference. The 1-year rates of the Child-Pugh score deterioration of ≥2 in case and control groups were 23.8% and 33.3% (P > 0.05), respectively.
The short-term administration of RFA and SBRT to the same BCLC stage 0-B1 patients may be feasible and effective because of their good prognosis and safety.
评估射频消融(RFA)和立体定向体放射治疗(SBRT)在巴塞罗那临床肝癌(BCLC)分期 0-B1 同一患者中的短期安全性和有效性。
从 2014 年 4 月至 2019 年 6 月,我们回顾性分析了 72 例接受 RFA(对照组)和 26 例接受 RFA 后序贯 SBRT(病例组)的 BCLC 分期 0-B1 初治单发肝癌患者的资料。采用倾向评分匹配(PSM)降低两组间选择偏倚。记录并分析两组患者的复发、生存、Child-Pugh 评分和短期不良反应(发热、出血、皮肤改变、腹痛和乏力)。
PSM 后每组各 21 例患者。病例组和对照组分别有 17 例和 20 例患者出现复发。对于这些患者,中位无进展生存时间和随访时间分别为 10.7 个月和 35.8 个月。PSM 后,病例组和对照组的 1 年无进展生存率分别为 66.7%和 52.4%(P = 0.313)。两组总体生存(OS)差异无统计学意义(病例组 3 年和 5 年 OS 率分别为 87.3%和 74.8%,对照组分别为 73.7%和 46.3%;P = 0.090)。短期不良反应轻微,两组间差异无统计学意义。病例组和对照组 Child-Pugh 评分恶化≥2 的 1 年发生率分别为 23.8%和 33.3%(P > 0.05)。
对 BCLC 分期 0-B1 同一患者短时间内序贯 RFA 和 SBRT 治疗可能是可行和有效的,因为其具有良好的预后和安全性。