Clinical Research Papers:
The effect of radiotherapy in liver-confined but non-resectable Barcelona Clinic Liver Cancer stage C large hepatocellular carcinoma
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Hong In Yoon1,4, Inkyung Jung2, Kwang-Hyub Han3,4 and Jinsil Seong1,4
1 Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
2 Department of Biostatistics & Medical Informatics, Yonsei University College of Medicine, Seoul, Korea
3 Department of Internal Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
4 Korean Liver Cancer Study Group, Seoul, Korea
Jinsil Seong, email:
Keywords: large hepatocellular carcinoma, radiotherapy, BCLC stage C, median survival time, propensity score matching
Received: April 13, 2016 Accepted: June 17, 2016 Published: July 28, 2016
Background and aims: Clinical trials to determine the efficacy of radiotherapy (RT) in liver-confined but non-resectable Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) are scarce. We aimed to determine the benefit of RT in such tumors and investigated large HCC tumors.
Methods: HCC data from the Korea Central Cancer Registry recorded from 2008 to 2010 were used. A total of 593 patients met our inclusion criteria; 67 were treated with RT while the remainder made up the non-RT group. Fifty-two RT recipients underwent combination treatments within 4 weeks after the first RT treatment, and were defined as the combination RT group. We performed propensity score matching (PSM) to compare the RT or combination RT groups with the non-RT group. The endpoint was overall survival (OS).
Results: Median follow-up time for surviving patients was 48 months. After PSM, there was no difference in OS between the RT and non-RT groups or between the combination RT and non-RT groups. However, the combination RT group had a longer median survival time (MST) (10.7 vs. 6.9 months, respectively). Next, we conducted PSM between the combination RT and non-RT groups in patients with tumor sizes ≥10 cm; MST was significantly longer in the former group (10.1 vs. 5.4 months, respectively; bootstrap 95% confidence interval of the difference in MST: 0.2-11.8).
Conclusions: As a combined modality, RT is a plausible therapeutic option for liver-confined but non-resectable BCLC stage C large HCC patients.
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