Stereotactic body radiotherapy for hepatocellular carcinoma – still searching for a role

Meyer, Tim

doi:10.1016/j.jhep.2020.04.019

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…These findings should prompt confirmatory randomized trials with standardized dose regimens to define the role of SBRT in the management of localized HCC. Until the results of these data are available, the use of SBRT should be limited to clinical trials and patients who are no surgical candidates [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Body Radiation Therapy versus Surgical Resection for Stage I/II Hepatocellular Carcinoma

Birgin

Hetjens

Tam

et al. 2023

Cancers

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SBRT is an emerging locoregional treatment modality for hepatocellular carcinoma (HCC). Although local tumor control rates seem encouraging, large-scale survival data comparing SBRT to surgical resection are lacking. We identified patients with stage I/II HCC from the National Cancer Database amenable for potential surgical resection. Patients undergoing hepatectomy were matched by propensity score (1:2) with patients who underwent SBRT as primary treatment. A total of 3787 (91%) and 366 (9%) patients underwent surgical resection or SBRT between 2004 and 2015, respectively. After propensity matching, the 5-year overall survival was 24% (95% CI 19–30%) in the SBRT group versus 48% (95% CI 43–53%) in the surgery group (p < 0.001). The association of surgery with overall survival was consistent in all subgroups. In patients treated with SBRT, a biologic effective dose (BED) of ≥100 Gy (31%, 95% CI 22%–40%) compared with BED < 100 Gy (13%, 95% CI 8–22%) was associated with a higher 5-year overall survival rate (hazard ratio of mortality of 0.58, 95% CI 0.43–0.77; p < 0.001). Surgical resection may be associated with prolonged overall survival compared with SBRT in patients with stage I/II HCC.

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Section: Discussionmentioning

confidence: 99%

Stereotactic Body Radiation Therapy versus Surgical Resection for Stage I/II Hepatocellular Carcinoma

Birgin

Hetjens

Tam

et al. 2023

Cancers

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“…These findings are expected to guide doctors during future decision making on the best treatment modality for HCC. Previous studies have shown that external radiotherapy can play a crucial role in management of HCC [68][69][70][71]. Notably, researchers have recommended that more focus should be directed to the importance of radiotherapy and radiotherapy combined with targeted therapy during treatment of unresectable HCC.…”

Section: Discussionmentioning

confidence: 99%

External radiotherapy combined with sorafenib has better efficacy in unresectable hepatocellular carcinoma: a systematic review and meta-analysis

Chen

et al. 2022

Clin Exp Med

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Advanced hepatocellular carcinoma (HCC) has a very low resectable rate. This meta-analysis aimed to compare efficacy of three combination strategies in treatment of advanced unresectable HCC with a view of guiding future selection of the best combination therapy for sorafenib and local therapy. A search was conducted to identify relevant literature published between April 2013 and May 2022, and then compared efficacy of sorafenib combined with external radiotherapy (SOF + RT), sorafenib with transarterial chemoembolization (SOF + TACE), sorafenib with hepatic artery infusion chemotherapy (SOF + HAIC), sorafenib (SOF), external radiotherapy (RT), transarterial chemoembolization (TACE), and hepatic artery infusion chemotherapy (HAIC) were studied and analyzed. Finally, the results were statistically analyzed using R 3.5.3 software and Stata/SE 15.0 software. A total of 46 studies, involving 7595 patients, were included in the meta-analysis. Analysis of overall survival (OS) and progression-free survival (PFS) of seven related treatment interventions revealed that the combination therapy had significantly higher efficacy than monotherapies. Among the combination therapies, SOF + RT was associated with the best OS and PFS rates, and the least adverse events compared to the other treatment modalities. The efficacy of combination therapy was better than monotherapy. In combination therapy, the overall survival time and progression-free survival time of SOF + RT were longer, and the adverse reactions were less. Therefore, SOF + RT may be the best choice for sorafenib combined with local therapy.

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“…Currently, surgical treatment is still the main approach to obtain a radical cure for HCC, including early hepatectomy and liver transplantation, with a 5-year survival rate of up to 70% (3). For patients with advanced HCC, various non-surgical treatments such as Transcatheter arterial chemoembolization (TACE), local ablation therapy, radiotherapy, and molecular targeted drug therapy with sorafenib can be selected (4)(5)(6)(7)(8). However, the treatment of advanced HCC is still insufficient and the tumor is prone to invasion, metastasis, and recurrence, resulting in a low overall survival (OS) rate, high mortality, and a poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

Current progress of immune checkpoint inhibitors in the treatment of advanced hepatocellular carcinoma

Yin

Lan

et al. 2022

Bioscience Reports

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Hepatocellular carcinoma (HCC) is the most common primary liver cancer worldwide. The onset of the disease is occult and develops rapidly. As a result, the disease is often detected when it is already in advanced stages, resulting in patients losing the best opportunity for liver transplantation and surgical treatment. Therefore, effective treatment of HCC is particularly important in clinical practice. During the past decades, there have been considerable advances in the treatment of HCC, and immunotherapy is increasingly recognized as a promising approach in clinical trials. In this review, an overview of immune checkpoint (ICP) inhibitors (ICIs) and their role in the treatment of liver cancers, particularly advanced HCC, is presented and the recent therapeutic progress with treatment with different ICIs alone or in combination with other methods/therapeutic agents is summarized. In addition, the identification of biomarkers to predict treatment response and the limitations of current ICIs are analyzed, and future directions for ICI treatment are discussed.

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Stereotactic body radiotherapy for hepatocellular carcinoma – still searching for a role

Cited by 7 publications

References 9 publications

Stereotactic Body Radiation Therapy versus Surgical Resection for Stage I/II Hepatocellular Carcinoma

Stereotactic Body Radiation Therapy versus Surgical Resection for Stage I/II Hepatocellular Carcinoma

External radiotherapy combined with sorafenib has better efficacy in unresectable hepatocellular carcinoma: a systematic review and meta-analysis

Current progress of immune checkpoint inhibitors in the treatment of advanced hepatocellular carcinoma

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