Department of Clinical Oncology and Nuclear Medicine, Cairo University, Cairo, Egypt.
Department of Radio Diagnosis and Interventional Radiology, Cairo University, Cairo, Egypt.
Asian Pac J Cancer Prev. 2024 Sep 1;25(9):3073-3079. doi: 10.31557/APJCP.2024.25.9.3073.
Both Stereotactic Body Radiation Therapy (SBRT) and Trans-arterial Chemoembolization (TACE) are now being widely used to treat advanced hepatocellular carcinoma (HCC) and can improve tumor local control rates. We aimed at evaluating the efficacy and toxicity of combining SBRT and TACE in comparison to TACE alone in unresectable HCC.
42 unresectable Barcelona Clinic Liver Cancer (BCLC) stage B HCC Child Pugh (CP) A patients were randomized to receive either: TACE alone (Arm A) or TACE followed by SBRT (Arm B). Dose prescribed was 40Gy in 5consecutive daily fractions over 1 week . We compared the local control (LC), Progression free survival (PFS), overall survival (OS) and toxicity between the two arms.
22 patients were in arm A versus 20 patients in arm B with median follow up 20 months starting recruitment from April 2021 till January 2023. Both LC, PFS were significantly better in Arm B. Complete remission (CR) rate was 54.5% and 75% in Arm A and B, respectively. Median PFS was 16 months in Arm B compared to 11 months in Arm A (p =0.003). Median OS was not reached in both arms. Both arms had comparable toxicities.
Adding SBRT to TACE in advanced HCC, is safe and feasible with better efficacy in terms of LC and PFS with comparable side effects, in comparison to TACE alone.
立体定向体部放射治疗（SBRT）和经动脉化疗栓塞（TACE）现在广泛用于治疗晚期肝细胞癌（HCC），并可以提高肿瘤局部控制率。我们旨在评估与单独 TACE 相比，SBRT 联合 TACE 在不可切除 HCC 中的疗效和毒性。
42 例不可切除的巴塞罗那临床肝癌（BCLC）分期 B、Child-Pugh（CP）A 期 HCC 患者被随机分为单独 TACE 组（A 组）或 TACE 后 SBRT 组（B 组）。规定剂量为 40Gy，连续 5 天，每天 1 次，共 5 次。我们比较了两组之间的局部控制（LC）、无进展生存期（PFS）、总生存期（OS）和毒性。
A 组有 22 例患者，B 组有 20 例患者，从 2021 年 4 月开始招募，随访中位数为 20 个月，直至 2023 年 1 月。两组的 LC 和 PFS 均明显更好。A 组和 B 组的完全缓解（CR）率分别为 54.5%和 75%。B 组的中位 PFS 为 16 个月，而 A 组为 11 个月（p=0.003）。两组的中位 OS 均未达到。两组的毒性相当。
与单独 TACE 相比，在晚期 HCC 中，SBRT 联合 TACE 是安全可行的，在 LC 和 PFS 方面具有更好的疗效，同时具有相当的副作用。
