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Open AccessArticle

Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib

by 1,2,†, 2,3,†, 2,3, 2,3, 1,2, 1,2, 1,2, 1,2, 2,4, 2,3 and 1,2,*
1
Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
2
State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou 510060, China
3
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
4
Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Cancers 2018, 10(12), 516; https://doi.org/10.3390/cancers10120516
Received: 3 November 2018 / Revised: 7 December 2018 / Accepted: 12 December 2018 / Published: 14 December 2018
Stereotactic body radiotherapy (SBRT) has shown promising results in the control of macroscopic vascular invasion in patients with hepatocellular carcinoma (HCC); however, its efficacy in comparison to sorafenib when combined with transarterial chemoembolization (TACE) remains to be determined. Between 2009 and 2017, 77 HCC patients with macroscopic vascular invasion receiving TACE–SBRT or TACE–sorafenib combination therapies were enrolled. The best treatment responses, overall survival (OS), and progression-free survival (PFS) of the two treatment arms were compared. Of the patients enrolled, 26 patients (33.8%) received TACE–SBRT treatment, and 51 (66.2%) received TACE–sorafenib treatment. The patients in the TACE–SBRT group were more frequently classified as elder in age (p = 0.012), having recurrent disease (p = 0.026), and showing lower rates of multiple hepatic lesions (p = 0.005) than patients in TACE–sorafenib group. After propensity score matching (PSM), 26 pairs of well-matched HCC patients were selected; patients in the TACE–SBRT group showed better overall response rates in trend compared to those in the TACE–sorafenib group. The hazard ratio (HR) of OS to PFS for the TACE–SBRT approach and the TACE–sorafenib approach was 0.36 (95% CI, 0.17–0.75; p = 0.007) and 0.35 (95% CI, 0.20–0.62; p < 0.001), respectively. For HCC patients with macrovascular invasion, TACE plus SBRT could provide improved OS and PFS compared to TACE–sorafenib therapy. View Full-Text
Keywords: hepatocellular carcinoma; macrovascular invasion; stereotactic body radiotherapy; sorafenib; transarterial chemoembolization hepatocellular carcinoma; macrovascular invasion; stereotactic body radiotherapy; sorafenib; transarterial chemoembolization
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Shen, L.; Xi, M.; Zhao, L.; Zhang, X.; Wang, X.; Huang, Z.; Chen, Q.; Zhang, T.; Shen, J.; Liu, M.; Huang, J. Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib. Cancers 2018, 10, 516.

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