Survival benefit of radiotherapy in patients with inoperable hepatocellular carcinoma: a propensity score matching study

Abstract

Background In recent years, with the development of radiotherapy (RT), several studies have shown that RT can significantly prolong the survival of hepatocellular carcinoma (HCC) patients. As a noninvasive treatment option, the application of RT for HCC is gradually gaining attention. Patients and methods: This retrospective study included data from 13,878 patients with HCC collected from the SEER database between 2000 and 2019 and 325 patients with HCC treated in three tertiary hospitals in China between 2015 and 2021. Patient data were divided into RT and non-RT groups based on whether the patients had received RT. Propensity score matching (PSM) analysis was used to minimize the deviation between the RT and non-RT groups, and the Kaplan-Meier method and Cox proportional hazard model were used to assess the efficacy of receiving RT. Results The median overall survival (mOS) was significantly longer in the RT group than in the non-RT group for SEER data (16 months vs 9 months, p < 0.01). Similarly, the survival benefit was more significant in the RT vs non-RT groups of patients at our hospitals (34.1 months vs 15.4 months, p < 0.01). In addition, multivariate Cox analysis showed that factors such as tumor (T) stage, patient age, tumor grade, serum AFP level and chemotherapy also affected patient survival. Subgroup analysis of these factors showed that RT was effective in prolonging patient survival in different populations. Conclusion RT significantly improves the survival time of patients with inoperable HCC, providing a basis for selecting HCC patients who will benefit from RT.