质子束疗法与BCLCB期肝细胞癌的跨动脉化学栓塞-a倾向匹配分析
Tzu-Ting Liu1, Bing-Shen Huang1,2,3, Yu-Ming Wang1,4,5
1Department of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
概括
质子束疗法 (PBT) 与中期肝细胞癌 (HCC) 的跨动脉化学栓塞 (TACE) 相比,提供了更好的生存率和更好的肝功能保护. 这项研究强调PBT是符合条件的患者的优越选择.
科学领域:
- 肝胆瘤学 肝胆瘤学
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 中期肝细胞癌 (HCC) 的管理仍然具有挑战性.
- 质子束疗法 (PBT) 是有前途的,但它对跨动脉化学栓塞 (TACE) 对巴塞罗那诊所肝癌 (BCLC) B期HCC的生存益处尚未得到充分证实.
- 需要现实世界的数据来比较PBT和TACE在这个患者群体中.
研究的目的:
- 为了比较PBT与TACE的实际总生存 (OS) 和肝功能结果,在患有BCLC阶段B HCC的患者中比较PBT与TACE.
- 评估PBT作为单一治疗对中期HCCTACE的疗效.
主要方法:
- 一个使用多机构数据的倾向分数匹配 (PSM) 队列研究.
- 包括接受PBT或TACE单独治疗的BCLC B期HCC未经治疗的患者.
- 评估治疗后的整体存活率 (OS) 和白蛋白-白素 (ALBI) 等级.
主要成果:
- 该PSM队列包括340名患者 (68名PBT,272名TACE).
- PBT证明了显著的生存益处 (p=0.032,HR 0.64).
- 与TACE (p=0.006) 相比,接受PBT的患者在治疗后保持了更好的肝功能 (ALBI等级).
结论:
- 质子束疗法 (PBT) 提供优越的整体存活率 (OS) 符合条件的患者与BCLC B期肝细胞癌 (HCC).
- 与跨动脉化学栓塞 (TACE) 相比,PBT可以更好地保护肝功能.
- 在可行的情况下,PBT是中期HCC的推治疗选择.
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