Han Lian-Qiang
Clinical Medicine of Hebei Medical University (Post-doctoral Mobile Station of The Second Hospital), Shijiazhuang, Hebei, China.
Department of Gastroenterology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Sci Rep. 2025 Apr 7;15(1):11823. doi: 10.1038/s41598-025-91992-z.
Apart from beam radiation (BR), treatment with radioactive implants (RI) was another important modality of cancer therapy. The main purpose was to explore which radiotherapy combined with chemotherapy was more beneficial and identify factor related to prognosis for patients with unresectable hepatocellular carcinoma (HCC). Patients were collected from the surveillance, epidemiology, and end results (SEER) database and were divided into RI group and BR group. Overall survival (OS) and HCC-specific survival were compared between two groups. Propensity score matched (PSM) was used to reduce baseline differences between the two groups. Univariate and multivariate Cox analysis were used to determine the factors affecting the prognosis, and a nomogram model was constructed based on independent risk factors. A total of 1481 HCC patients from 2000 to 2019 were enrolled, including 502 in RI group and 979 in BR group. After PSM, 376 pairs of matched cases were selected. In the matched cohort, there was no significant difference in the median OS (RI vs. BR, 15 vs. 17 months, P = 0.616) and HCC-specific survival (RI vs. BR, 18 vs. 21 months, P = 0.154) between the two groups. Subgroup analysis of different stages also showed no significant difference. Multivariate Cox analysis also did not indicate a significant prognostic difference between the two groups. Based on the independent risk factors of OS such as AFP, grade, TNM staging, and M1, a nomogram model was constructed and verified. When combined with chemotherapy in the treatment of unresectable HCC, RI demonstrated comparable prognostic outcomes to BR, suggesting its potential as an alternative treatment option. In addition, the constructed nomogram model might be able to intuitively and accurately predict the prognosis of unresectable HCC patients receiving chemotherapy combined with radiotherapy.
除了束流辐射（BR）外，放射性植入物治疗（RI）是癌症治疗的另一种重要方式。主要目的是探讨哪种放疗联合化疗更有益，并确定不可切除肝细胞癌（HCC）患者的预后相关因素。从监测、流行病学和最终结果（SEER）数据库收集患者，并分为RI组和BR组。比较两组的总生存期（OS）和HCC特异性生存期。采用倾向评分匹配（PSM）来减少两组之间的基线差异。使用单因素和多因素Cox分析来确定影响预后的因素，并基于独立危险因素构建列线图模型。共纳入2000年至2019年的1481例HCC患者，其中RI组502例，BR组979例。经过PSM后，选择了376对匹配病例。在匹配队列中，两组之间的中位OS（RI组与BR组，15个月对17个月，P = 0.616）和HCC特异性生存期（RI组与BR组，18个月对21个月，P = 0.154）无显著差异。不同分期的亚组分析也未显示出显著差异。多因素Cox分析也未表明两组之间存在显著的预后差异。基于AFP、分级、TNM分期和M1等OS的独立危险因素构建并验证了列线图模型。在不可切除HCC的治疗中，当与化疗联合使用时，RI显示出与BR相当的预后结果，表明其作为替代治疗选择的潜力。此外，构建的列线图模型可能能够直观、准确地预测接受化疗联合放疗的不可切除HCC患者的预后。
