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Stereotactic body radiotherapy versus lenvatinib for hepatocellular carcinoma with portal vein tumor thrombosis: a propensity matching score analysis
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Stereotactic body radiotherapy versus lenvatinib for hepatocellular carcinoma with portal vein tumor thrombosis: a propensity matching score analysis
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Journal Article
Stereotactic body radiotherapy versus lenvatinib for hepatocellular carcinoma with portal vein tumor thrombosis: a propensity matching score analysis
2024
Overview
Background and objectives
The purpose of this study was to investigate the survival benefit of Stereotactic Body Radiotherapy (SBRT) versus lenvatinib as first-line therapy in the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT).
Materials and methods
147 HCC patients with PVTT were included in this retrospective study, 70 were treated with SBRT and 77 of were treated with lenvatinib. Propensity score matching (PSM) analysis was employed to balance the differences in baseline characteristics between the two groups. Overall survival (OS), progression-free survival (PFS) and objective response rate (ORR) were compared between the two groups. In addition, the safety of patients in both groups was also evaluated.
Results
After PSM, 38 patients were matched in each of the two groups. The median OS was 14.5 (95% CI: 10.1–18.9) and 11.1 (95% CI: 9.3–12.9) months in the SBRT and lenvatinib groups, respectively (
P
= 0.014). The median PFS was 6.8 (95% CI: 5.1–8.5) and 5.0 (95% CI: 3.0–7.0) months, respectively (
P
= 0.010). The 1-, 2-years OS rates in the two groups were 65.8% vs. 39.5% and 31.6% vs. 10.5%, respectively. The 6-, 12-months PFS rates in the two groups were 57.9% vs. 44.7% and 28.9% vs. 10.5%, respectively. In addition, the SBRT group had a better ORR than the lenvatinib group (52.6% vs. 23.7%,
P
= 0.009). Patients with good response to SBRT had better survival. Cox proportional hazard model showed that SBRT was an important prognostic factor for OS and PFS. The incidence of hypertension (34.2% vs. 0%) was higher in the LEN group, however, both treatment modalities were well tolerated in the two groups of patients.
Conclusion
In HCC patients with PVTT, SBRT had a better survival benefit than Lenvatinib treatment as first-line therapy.
Publisher
BioMed Central,BioMed Central Ltd,BMC
Subject
/ Aged
/ Antineoplastic Agents - therapeutic use
/ Biomedical and Life Sciences
/ Carcinoma, Hepatocellular - complications
/ Carcinoma, Hepatocellular - pathology
/ Carcinoma, Hepatocellular - radiotherapy
/ Complications and side effects
/ Female
/ Hepatoma
/ Humans
/ Imaging
/ Liver Neoplasms - radiotherapy
/ Male
/ Oncology
/ Phenylurea Compounds - therapeutic use
/ Portal vein tumor thrombosis
/ Quinolines - therapeutic use
/ Radiosurgery - adverse effects
