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JAMA sub-joined intensity-modulated radiotherapy combined with surgery for central hepatocyte hepatocyte cancer safe and effective
▎ Clinical problems:
Central hepatocyte carcinoma (HCC) is a special type of liver cancer . The effect of pure surgical treatment is not ideal. At present, there is no standard auxiliary or neoadjuvant treatment to improve clinical results. Whether neoadjuvant intensity-modulated radiation therapy (IMRT) combined with surgery for HCC is safe and effective is not yet known.
A study from the JAMA sub-buried journal shows that IMRT combined with surgery for HCC is safe and effective.
▎ Research Protocol:
This phase 2, single-center, single-group prospective non- randomized controlled trial was conducted at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China from December 16, 2014 to January 29, 2019. The last follow-up was July 30, 2021. Patients with central HCC who underwent neoadjuvant IMRT and surgery were included in the analysis. The intervention measures were liver resection after neoadjuvant IMRT treatment. The primary endpoint is 5-year overall survival (OS). The secondary endpoints were tumor response to IMRT, 5-year disease-free survival (DFS), and treatment-related adverse events .
▎ Mainly found:
(1)38 patients [mean (SD) age, 55.6 (9.3) years; 35 were male (92.1%)] completed the specified new assisted IMRT without interruption.
(2) The imaging response to IMRT before surgery included partial responses [16 cases (42.1%)] and stable disease [22 cases (57.9%)]. 13 patients (34.2%) had major pathological reactions, and 5 of them (13.2%) had complete pathological reactions. The median follow-up time of
(3) was 45.8 months, not reaching the median OS, with a 1-year OS rate of 94.6%, 75.4% in 3 years, and 69.1% in 5 years. The median DFS was 45.8 months, the 1-year DFS rate was 70.3%, 3-year 54.1%, and 5-year 41.0%.
(4) Grade 3 adverse events related to radiotherapy were observed in 3 patients (7.9%). 19 surgical complications (34.2%) occurred in 13 patients, including grade I to II complications in 12 patients (31.6%) and grade IIIa complications in 1 patient (2.6%). No surgical complications of grade IIIb or higher were observed.
▎ Outlook:
To sum up, neoadjuvant IMRT combined with surgery for central HCC patients is effective and well tolerated. These data may provide reference for future randomized clinical trials of this new therapeutic strategy.
References:
[1]https://jamanetwork.com/journals/jamasurgery/fullarticle/2797090
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This article was first published: Medical World Tumor Channel
Author: Dingchao Jingyao Group
Editor: Sweet
Copyright Statement
This article is original If you need to reprint, please contact the authorization
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