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热除与肝细胞癌的立体体辐射疗法相比:一个多中心回顾性比较研究
Andrew M Moon1,2, Hannah P Kim3, Amit G Singal4
1Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.
Hepatology communications
|June 14, 2023
概括
立体体辐射疗法 (SBRT) 与热性切除相比,减少了早期肝细胞癌 (HCC) 的局部进展. 然而,SBRT也增加了肝功能障碍和HCC患者的死亡风险.
科学领域:
- 肝细胞癌 (HCC) 研究研究
- 辐射瘤学 辐射瘤学
- 干预性放射学 干预性放射学
背景情况:
- 早期肝细胞癌 (HCC) 可以通过热切除或立体体辐射疗法 (SBRT) 治疗.
- 美国进行了一项多中心队列研究,以比较这些治疗方式.
- 该研究侧重于HCC患者的局部进展,死亡率和毒性.
研究的目的:
- 为了回顾性地比较热除与SBRT对于早期HCC的结果.
- 评估局部进展,整体存活率和与治疗相关的毒性差异.
- 为HCC管理的临床决策提供信息.
主要方法:
- 对未经治疗的HCC病变没有血管侵袭的成年患者的回顾性分析.
- 包括在2012年1月至2018年12月期间接受热废除或SBRT治疗的患者.
- 使用治疗权重的逆概率 (IPTW) 和Cox比例危险/逻辑回归模型进行调整的分析.
主要成果:
- 与热性废除相比,SBRT与局部进展的风险显著降低 (aHR 0.30).
- 然而,接受SBRT治疗的患者经历了3个月的肝功能障碍风险增加 (aOR 2.31) 和更高的全因死亡率 (aHR 2.04).
- 总共分析了786个病变的642名患者.
结论:
- 对HCC而言,SBRT显示局部进展的风险低于热性废除.
- SBRT与全因死亡率的增加有关,可能是由于混因素或下游治疗变化.
- 现实世界的数据支持SBRT在本地控制中的有效性,但强调需要前性试验来澄清生存结果.
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