Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China.
Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor(Guangxi Medical University), Nanning, Guangxi, China.
Langenbecks Arch Surg. 2024 Mar 15;409(1):97. doi: 10.1007/s00423-024-03249-4.
This study was recruited to compare the efficacy and safety of radiotherapy (RT) and transarterial chemoembolization (TACE) as postoperative adjuvant therapy after narrow-margin hepatectomy in hepatocellular carcinoma (HCC) patients.
This single-center prospective randomized study was conducted in the Cancer Hospital, Guang Xi Medical University, Nanning. A total of 72 patients who received treatment in this hospital between August 2017 and July 2019 were included and randomly allocated to TACE group (n = 48) and RT group (n = 24). Next, overall survival (OS) and progression-free survival (PFS) rates, recurrence patterns, financial burden, and safety were evaluated.
The difference between the RT and TACE groups was not significant in one-, three-, and five-year OS (87.5%, 79.0%, and 62.5% vs. 93.8%, 75.9%, and 63.4%, respectively, P = 0.071) and PFS rates (79.0%, 54.2%, and 22.6% vs. 75.0%, 47.9%, and 32.6%, respectively, P = 0.071). Compared to the TACE group, the RT group had significantly lower intrahepatic recurrence rate (20.8% vs. 52.1%, P = 0.011), higher extrahepatic recurrence rate (37.5% vs. 14.6%, P = 0.034), and no marginal and diffuse recurrences (0% vs. 16.7%, P < 0.05). The mean overall treatment cost was higher (¥62,550.59 ± 4397.27 vs. ¥40,732.56 ± 9210.54, P < 0.01), the hospital stay (15.1 ± 3.7 vs. 11.8 ± 4.1 days, P < 0.01) was longer, and the overall treatment stay (13.3 ± 5.3 vs. 41.29 ± 12.4 days, P < 0.01) was shorter in the TACE group than in the RT group. Besides, both groups did not exhibit significant differences in the frequency and severity of adverse events.
Both adjuvant TACE and RT can better the OS and PFS of patients with HCC. However, RT has a significantly better performance than TACE in terms of improving intrahepatic recurrence rate, treatment cost and hospital stay.
本研究旨在比较肝癌患者肝切除术后边缘狭窄患者接受放疗（RT）和经动脉化疗栓塞术（TACE）作为辅助治疗的疗效和安全性。
本单中心前瞻性随机研究在广西医科大学附属肿瘤医院进行。2017 年 8 月至 2019 年 7 月期间在该院接受治疗的 72 例患者被纳入并随机分配至 TACE 组（n=48）和 RT 组（n=24）。随后，评估了总生存期（OS）和无进展生存期（PFS）率、复发模式、经济负担和安全性。
RT 组和 TACE 组在 1 年、3 年和 5 年 OS（分别为 87.5%、79.0%和 62.5% vs. 93.8%、75.9%和 63.4%，P=0.071）和 PFS 率（分别为 79.0%、54.2%和 22.6% vs. 75.0%、47.9%和 32.6%，P=0.071）方面无显著差异。与 TACE 组相比，RT 组的肝内复发率显著降低（20.8% vs. 52.1%，P=0.011），肝外复发率显著升高（37.5% vs. 14.6%，P=0.034），且无边缘性和弥漫性复发（0% vs. 16.7%，P<0.05）。总的治疗费用较高（¥62550.59±4397.27 比 ¥40732.56±9210.54，P<0.01），住院时间较长（15.1±3.7 比 11.8±4.1 天，P<0.01），总的治疗时间较短（13.3±5.3 比 41.29±12.4 天，P<0.01）。此外，两组在不良反应的发生频率和严重程度方面无显著差异。
辅助 TACE 和 RT 均可改善 HCC 患者的 OS 和 PFS。然而，与 TACE 相比，RT 在改善肝内复发率、治疗费用和住院时间方面表现更好。
