Stereotactic Body Radiation Therapy vs. Transarterial Chemoembolization in Inoperable Barcelona Clinic Liver Cancer Stage a Hepatocellular Carcinoma: A Retrospective, Propensity-Matched Analysis

作者：Ting‐Shi Su, Ping Liang, Ying Zhou, Yong Huang, Tao Cheng, Song Qu, Long Chen, Bang‐De Xiang, Chang Zhao, De‐Jia Huang, Shi‐Xiong Liang, Le‐Qun Li · 发表于：Frontiers in Oncology · 年份：2020 · DOI：10.3389/fonc.2020.00347 · 被引用次数：47 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Liver Disease Diagnosis and Treatment、Cancer Mechanisms and Therapy

Background and Objective: It is unclear if stereotactic body radiation therapy (SBRT) or transarterial chemoembolization (TACE) is better for the treatment of inoperable early-stage hepatocellular carcinoma (HCC). This study aimed to retrospectively compare the efficacy of SBRT to TACE in patients with inoperable Barcelona Clinic Liver Cancer (BCLC)-A stage HCC. Materials and Methods: In this multi-institutional retrospective study, a total of 326 patients with inoperable BCLC-A stage HCC were enrolled. Totally, 167 patients initially received SBRT and 159 initially received TACE. Overall survival (OS), local control (LC), intrahepatic control (IC), and progression-free survival (PFS) were evaluated in univariable and propensity-score matched analyses. Results: There was a smaller median tumor size in the SBRT group than in the TACE group (3.4 cm versus 7.2 cm, P<.001). After propensity score matching in the selection of 95 patient pairs, SBRT had better LC, IC, and PFS than TACE but showed comparable OS. The accumulative 1-, 3-, and 5-year OS rates were 85.7%, 65.1%, and 62.8% in the SBRT group and 83.6%, 61.0%, and 50.4% in the TACE group, respectively (P=.29). The accumulative 1-, 3-, and 5-year PFS were 63.4%, 35.9%, and 27.5% in the SBRT group and 53.5%, 27.4%, and 14.2% in the TACE group, respectively (P=.049). The accumulative 1-, 3-, and 5-year LC were 86.8%, 62.5%, and 56.9% in the SBRT group and 69.3%, 53.3%, and 36.6% in the TACE group, respectively (P=.0047). The ...