Joo Jihyeon, Jeon Hosang, Kim Dongwoon, Kim Wontaek, Nam Jiho, Kim Donghyun, Park Dahl, Kim Choongrak, Ki Yongkan
Department of Radiation Oncology, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea.
Department of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea.
Cancers (Basel). 2023 Jul 25;15(15):3777. doi: 10.3390/cancers15153777.
Assessment of liver function is crucial in predicting treatment outcomes for hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic performance of the albumin-bilirubin (ALBI) score for predicting hepatotoxicity following stereotactic body radiation therapy (SBRT) in HCC patients. A retrospective analysis was conducted on 123 HCC cases treated between 2018 and 2020. ALBI and Child-Turcotte-Pugh (CTP) scores were calculated, and hepatotoxicity was defined as a post-SBRT CTP score increase ≥2. Receiver operating characteristic (ROC) curves were used for comparison. The optimal cutoff value of the ALBI score was determined. Among the 121 patients analyzed, hepatotoxicity occurred in 5%. The ALBI score showed better predictive accuracy (area under the ROC curve: 0.77) than the CTP score. The optimal cutoff value of the ALBI score was -2.47, with a sensitivity of 85.7% and a specificity of 71.1%. Multivariable analysis revealed that ALBI score and PTV were significant factors for hepatotoxicity. In conclusion, the ALBI score demonstrated prognostic value for hepatotoxicity prediction after SBRT in HCC patients. Considering the ALBI score and PTV provides valuable insights for assessing hepatotoxicity risk during SBRT treatment for HCC.
肝功能评估对于预测肝细胞癌（HCC）的治疗结果至关重要。本研究旨在评估白蛋白-胆红素（ALBI）评分在预测HCC患者立体定向体部放射治疗（SBRT）后肝毒性方面的预后性能。对2018年至2020年间接受治疗的123例HCC病例进行了回顾性分析。计算了ALBI和Child-Turcotte-Pugh（CTP）评分，并将肝毒性定义为SBRT后CTP评分增加≥2。采用受试者工作特征（ROC）曲线进行比较。确定了ALBI评分的最佳临界值。在分析的121例患者中，5%发生了肝毒性。ALBI评分显示出比CTP评分更好的预测准确性（ROC曲线下面积：0.77）。ALBI评分的最佳临界值为-2.47，敏感性为85.7%，特异性为71.1%。多变量分析显示，ALBI评分和计划靶体积（PTV）是肝毒性的重要因素。总之，ALBI评分在预测HCC患者SBRT后的肝毒性方面具有预后价值。考虑ALBI评分和PTV为评估HCC患者SBRT治疗期间的肝毒性风险提供了有价值的见解。
