TY - JOUR
T1 - Stereotactic Body Radiation Therapy as an Alternative Treatment for Patients with Hepatocellular Carcinoma Compared to Sorafenib
T2 - A Propensity Score Analysis
AU - Bettinger, Dominik
AU - Pinato, David J.
AU - Schultheiss, Michael
AU - Sharma, Rohini
AU - Rimassa, Lorenza
AU - Pressiani, Tiziana
AU - Burlone, Michela E.
AU - Pirisi, Mario
AU - Kudo, Masatoshi
AU - Park, Joong Won
AU - Buettner, Nico
AU - Neumann-Haefelin, Christoph
AU - Boettler, Tobias
AU - Abbasi-Senger, Nasrin
AU - Alheit, Horst
AU - Baus, Wolfgang
AU - Blanck, Oliver
AU - Gerum, Sabine
AU - Guckenberger, Mathias
AU - Habermehl, Daniel
AU - Ostheimer, Christian
AU - Riesterer, Oliver
AU - Tamihardja, Jörg
AU - Grosu, Anca Ligia
AU - Thimme, Robert
AU - Brunner, Thomas Baptist
AU - Gkika, Eleni
N1 - Publisher Copyright:
© 2018 S. Karger AG, Basel.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background and Aims: Stereotactic body radiation therapy (SBRT) has emerged as a safe and effective treatment for patients with hepatocellular carcinoma (HCC), but its role in patients with advanced HCC is not yet defined. In this study, we aim to assess the efficacy and safety of SBRT in comparison to sorafenib treatment in patients with advanced HCC. Methods: We included 901 patients treated with sorafenib at six tertiary centers in Europe and Asia and 122 patients treated with SBRT from 13 centers in Germany and Switzerland. Medical records were reviewed including laboratory parameters, treatment characteristics and development of adverse events. Propensity score matching was performed to adjust for differences in baseline characteristics. The primary endpoint was overall survival (OS) and progression-free survival. Results: Median OS of SBRT patients was 18.1 (10.3-25.9) months compared to 8.8 (8.2-9.5) in sorafenib patients. After adjusting for different baseline characteristics, the survival benefit for patients treated with SBRT was still preserved with a median OS of 17.0 (10.8-23.2) months compared to 9.6 (8.6-10.7) months in sorafenib patients. SBRT treatment of intrahepatic lesions in patients with extrahepatic metastases was also associated with improved OS compared to patients treated with sorafenib in the same setting (17.0 vs. 10.0 months, p = 0.012), whereas in patients with portal vein thrombosis there was no survival benefit in patients with SBRT. Conclusions: In this retrospective comparative study, SBRT showed superior efficacy in HCC patients compared to patients treated with sorafenib.
AB - Background and Aims: Stereotactic body radiation therapy (SBRT) has emerged as a safe and effective treatment for patients with hepatocellular carcinoma (HCC), but its role in patients with advanced HCC is not yet defined. In this study, we aim to assess the efficacy and safety of SBRT in comparison to sorafenib treatment in patients with advanced HCC. Methods: We included 901 patients treated with sorafenib at six tertiary centers in Europe and Asia and 122 patients treated with SBRT from 13 centers in Germany and Switzerland. Medical records were reviewed including laboratory parameters, treatment characteristics and development of adverse events. Propensity score matching was performed to adjust for differences in baseline characteristics. The primary endpoint was overall survival (OS) and progression-free survival. Results: Median OS of SBRT patients was 18.1 (10.3-25.9) months compared to 8.8 (8.2-9.5) in sorafenib patients. After adjusting for different baseline characteristics, the survival benefit for patients treated with SBRT was still preserved with a median OS of 17.0 (10.8-23.2) months compared to 9.6 (8.6-10.7) months in sorafenib patients. SBRT treatment of intrahepatic lesions in patients with extrahepatic metastases was also associated with improved OS compared to patients treated with sorafenib in the same setting (17.0 vs. 10.0 months, p = 0.012), whereas in patients with portal vein thrombosis there was no survival benefit in patients with SBRT. Conclusions: In this retrospective comparative study, SBRT showed superior efficacy in HCC patients compared to patients treated with sorafenib.
KW - Hepatocellular carcinoma
KW - Overall survival
KW - Propensity score analysis
KW - Sorafenib
KW - Stereotactic body radiation therapy
UR - http://www.scopus.com/inward/record.url?scp=85049915849&partnerID=8YFLogxK
U2 - 10.1159/000490260
DO - 10.1159/000490260
M3 - Article
SN - 2235-1795
VL - 8
SP - 281
EP - 294
JO - Liver Cancer
JF - Liver Cancer
IS - 4
ER -