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. 2022 Sep 13;14(18):4445.
doi: 10.3390/cancers14184445.

Proton Beam Therapy for Treatment-Naïve Hepatocellular Carcinoma and Prognostic Significance of Albumin-Bilirubin (ALBI) Grade

Tae Hyun Kim  1   2 , Bo Hyun Kim  1 , Joong-Won Park  1 , Yu Ri Cho  1 , Young-Hwan Koh  1 , Jung Won Chun  1 , Eun Sang Oh  2 , Do Yeul Lee  2 , Sung Uk Lee  2 , Yang-Gun Suh  2 , Sang Myung Woo  1 , Sung Ho Moon  2 , Sang Soo Kim  2 , Woo Jin Lee  1
Affiliations

Proton Beam Therapy for Treatment-Naïve Hepatocellular Carcinoma and Prognostic Significance of Albumin-Bilirubin (ALBI) Grade

Tae Hyun Kim et al. Cancers (Basel). .

Abstract

To evaluate the efficacy of proton beam therapy (PBT) as an initial treatment in treatment-naïve hepatocellular carcinoma (HCC) patients and to assess the prognostic significance of albumin-bilirubin (ALBI) grade, 46 treatment-naïve HCC patients treated with PBT were analyzed. The ALBI grade distribution was grade 1 in 11 (23.9%) patients, grade 2 in 34 (73.9%) patients, and grade 3 in 1 (2.2%) patient. The median duration of follow-up was 56.5 months (95% confidence interval [CI], 48.2−64.7). Among the 46 patients, disease progression was observed in 23 (50%) patients: local progression in 3 (6.5%) patients; intrahepatic progression in 22 (47.8%); and extrahepatic progression in 5 (10.9%). The 5-year freedom from local progression (FFLP), progression-free survival (PFS), and overall survival (OS) rates were 92.7% (95% CI, 84.7−100.7), 43.3% (95% CI, 28.2−58.4), and 69.2% (95% CI, 54.9−83.5), respectively. In multivariate analysis, there were no independent factors for FFLP (p > 0.05 each), but tumor stage and ALBI grade were independent factors for PFS and OS (p < 0.05 each). PBT could result in comparable OS in treatment-naïve HCC patients to other recommended first-line treatments, and ALBI grade, in addition to tumor stage, could be useful for predicting OS.

Keywords: albumin-bilirubin; hepatocellular carcinoma; overall survival; proton beam therapy; radiotherapy.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patterns of disease progression at the time of analysis. (A) Initial sites of disease progression and (B) all sites of disease progression. Abbreviations: NED, no evidence of disease progression.
Figure 2
Figure 2
Progression-free survival (PFS) curves according to AJCC stage (A) and ALBI grade (B) in all patients, and overall survival (OS) curves according to AJCC stage (C) and ALBI grade (D). Abbreviations: AJCC stage, American Joint Committee on Cancer stage; ALBI grade, albumin-bilirubin grade. * log-rank test.
See this image and copyright information in PMC

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