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Stereotactic body radiation therapy as an alternative treatment for patients with hepatocellular carcinoma compared to sorafenib: a propensity score analysis

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Title: Stereotactic body radiation therapy as an alternative treatment for patients with hepatocellular carcinoma compared to sorafenib: a propensity score analysis
Authors: Bettinger, D
Pinato, DJ
Schultheiss, M
Sharma, R
Rimassa, L
Pressiani, T
Burlone, ME
Pirisi, M
Kudo, M
Park, JW
Buettner, N
Neumann-Haefelin, C
Boettler, T
Abbasi-Senger, N
Alheit, H
Baus, W
Blanck, O
Gerum, S
Guckenberger, M
Habermehl, D
Ostheimer, C
Riesterer, O
Tamihardja, J
Grosu, AL
Thimme, R
Brunner, TB
Gkika, E
Item Type: Journal Article
Abstract: 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.
Issue Date: 1-Jul-2019
Date of Acceptance: 20-May-2018
URI: http://hdl.handle.net/10044/1/61891
DOI: https://dx.doi.org/10.1159/000490260
ISSN: 2235-1795
Publisher: Karger
Start Page: 281
End Page: 294
Journal / Book Title: Liver Cancer
Volume: 8
Issue: 4
Copyright Statement: © 2018 S. Karger AG, Basel.
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
Gastroenterology & Hepatology
Hepatocellular carcinoma
Sorafenib
Stereotactic body radiation therapy
Propensity score analysis
Overall survival
CLINICAL-PRACTICE GUIDELINES
QUALITY-OF-LIFE
TRANSARTERIAL CHEMOEMBOLIZATION
LIVER-TUMORS
PHASE-I
RADIOTHERAPY
ABSCOPAL
OUTCOMES
BRIDGE
EFFICACY
Publication Status: Published
Online Publication Date: 2018-07-12
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine



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