글로벌 연구동향
방사선종양학
- 2022년 04월호
[J Gastroenterol Hepatol.] Role of radiotherapy in Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma treated with sorafenib서울특별시보라매병원, 서울의대 / 장원익, 김병혁*, 지의규*
- 출처
- J Gastroenterol Hepatol.
- 등재일
- 2022 Feb
- 저널이슈번호
- 37(2):387-394. doi: 10.1111/jgh.15722. Epub 2021 Nov 5.
- 내용
Abstract
Background and aim: This study aimed to investigate the clinical benefits of locoregional radiation therapy (RT) before, after, and concurrent with sorafenib therapy for Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) patients.Methods: Patients treated with sorafenib for BCLC stage C HCC between January 2015 and December 2017 were retrospectively reviewed. In this study, only RT to locoregional sites, including the primary HCC, tumor thrombosis, or lymph node metastasis, was analyzed. Propensity score matching was used to adjust important baseline characteristics between groups.
Results: Among 398 patients treated with sorafenib, 68 (17.1%) patients were treated with locoregional RT. Median progression-free survival and overall survival (OS) were 2.2 and 9.5 months, respectively. In the multivariate analysis, locoregional RT (P < 0.001) was associated with a favorable OS. After 1:1 propensity score matching, patients who did not receive locoregional RT showed a worse OS than those who received RT (median 9.6 vs 15.7 months, P = 0.017). Whereas locoregional RT before/concurrent with sorafenib did not result in prolonged OS, locoregional RT after sorafenib showed significantly prolonged OS compared with sorafenib without locoregional RT (P = 0.003). Moreover, patients treated with ≥ 12 weeks of sorafenib significantly benefited from locoregional RT (15.3 vs 23.6 months, P = 0.046).
Conclusion: Locoregional RT was associated with significantly longer survival in BCLC stage C HCC patients who were treated with sorafenib. Therefore, incorporating locoregional RT could improve the dismal prognosis for these patients.
Affiliations
Won Ick Chang 1 , Byoung Hyuck Kim 2 , Yoon Jun Kim 3 , Jung-Hwan Yoon 3 , Yong Jin Jung 4 , Eui Kyu Chie 1 5
1 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
2 Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
3 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
4 Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
5 Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
- 키워드
- Hepatocellular carcinoma; Radiation therapy; Sorafenib.
- 연구소개
- 방사선치료의 역할이 명확하지 않은 BCLC stage C 의 간암에서 sorafenib 사용 전후의 국소 및 영역림프절 방사선치료의 역할을 분석한 논문입니다. 본 연구에서 sorafenib 으로 치료받은 BCLC stage C 간암 환자에서 방사선치료의 사용한 환자들이 더 향상된 생존을 보였습니다. 따라서, 본 연구의 결과를 바탕으로 임상현장에서 BCLC stage C 간암 환자들에게 더욱 적극적으로 방사선치료를 고려할 수 있게 될 것이라고 생각됩니다.
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