Albumin-bilirubin versus Child-Pugh Grade as a Predictor of Survival after Individualised Hypofractionated Radiotherapy for Hepatocellular Carcinoma

Abstract

Purpose: To evaluate the ability of Child-Pugh (CP) versus albumin-bilirubin (ALBI) grade to predict overall survival (OS) in patients with hepatocellular carcinoma (HCC) undergoing individualised hypofractionated radiotherapy (IHRT) using stereotactic body radiotherapy (SBRT). Methods: We retrospectively reviewed data on our patients with HCC treated with IHRT using SBRT per our institutional protocol from May 2006 to February 2015. We collected CP and ALBI grades prior to treatment and analysed their prognostic value for OS. Results: A total of 174 consecutive patients were included in this study. Among them, 63% were CP grade A5 and 37% were A6. The median ALBI score was-2.39 (range,-3.61 to-1.41) with 35% grade A1 and 65% grade A2. OS was significantly associated with ALBI grade (p = 0.015), but not with CP grade (p = 0.47). On multivariable regression analysis, the ALBI score, tumour size, number of lesions, total biologically effective dose, presence of portal vein thrombosis, and the presence of metastasis were shown to be independent factors for OS. Conclusion: ALBI grade is a better predictor of survival than the CP grade in patients with HCC receiving IHRT.