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. 2017 May 17;12(5):e0177793.
doi: 10.1371/journal.pone.0177793. eCollection 2017.

Survival and prognostic factors for patients with advanced hepatocellular carcinoma after stereotactic ablative radiotherapy

Cheng-Hsiang Lo  1 , Jen-Fu Yang  1 , Ming-Yueh Liu  1 , Yee-Min Jen  1   2 , Chun-Shu Lin  1 , Hsing-Lung Chao  1 , Wen-Yen Huang  1   3
Affiliations

Survival and prognostic factors for patients with advanced hepatocellular carcinoma after stereotactic ablative radiotherapy

Cheng-Hsiang Lo et al. PLoS One. .

Abstract

Objective: To evaluate the survival outcomes and prognostic factors of patients with advanced hepatocellular carcinoma (HCC) who underwent stereotactic ablative radiotherapy (SABR).

Methods: This retrospective study evaluated patients with advanced HCC who underwent SABR between December 2007 and July 2015. All patients had Barcelona Clinic Liver Cancer stage C disease and Child-Turcotte-Pugh (CTP) class A-B function. In-field control (IFC), overall survival (OS), prognostic factors, and toxicity were evaluated.

Results: In this study of 89 patients, the 3-year IFC rate was 78.1%, and the 1-year and 3-year OS rates were 45.9% and 24.3%, respectively. The multivariate analysis revealed that CTP class, the presence of main portal vein tumor thrombosis, and the presence of extrahepatic spread were independent predictors of OS. The expected median OS values among patients with ≥2, 1, and 0 predictors were 4.2, 8.6, and 26.4 months, respectively (p <0.001).

Conclusions: SABR may be useful for patients with advanced HCC, and patient selection could be based on the CTP classification, main portal vein tumor thrombosis, and extrahepatic spread.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Kaplan–Meier curve of overall survival (OS).
The 1-year and 3-year OS rates were 45.9% and 24.3%, respectively. The median OS time was 10.9 months.
Fig 2
Fig 2. Overall survival of hepatocellular carcinoma patients with Child–Turcotte–Pugh class B vs. class A liver function (1-year OS, 6.8% vs. 57%).
Fig 3
Fig 3. Overall survival of hepatocellular carcinoma patients with main portal vein tumor thrombosis (mPVTT) vs. those without mPVTT (1-year OS, 18.7% vs. 56.1%).
Fig 4
Fig 4. Overall survival of hepatocellular carcinoma patients with extrahepatic spread (ES) vs. patients without ES (1-year OS, 14.8% vs. 59.8%).
Fig 5
Fig 5. Kaplan–Meier curve of overall survival (OS) as a function of the number of risk factors among hepatocellular carcinoma patients stratified by Child–Turcotte–Pugh classification, main portal vein tumor thrombosis, and extrahepatic spread.
The 1-year OS rates among patients with 0, 1 and ≥ 2 risk factors were 77.9%, 26.2%, and 6.7%, respectively.
See this image and copyright information in PMC

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