Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 12 / 09 / 2021




Hepatic Resection Versus Stereotactic Body Radiation Therapy Plus Transhepatic Arterial Chemoembolization for Large Hepatocellular Carcinoma: A Propensity Score Analysis

Jing Sun1,#, Wen-Gang Li1,#, Quan Wang1,#, Wei-Ping He1, Hong-Bo Wang2, Ping Han1, Tao Zhang1, Ai-Min Zhang1, Yu-Ze Fan1, Ying-Zhe Sun1 and Xue-Zhang Duan1,*

1  Radiation Oncology Department, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
2  Department of Hepatic Surgery, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
#These authors contributed equally to this work.
*Correspondence to:Xue-Zhang Duan, Radiation Oncology Department, Fifth Medical Center of Chinese PLA General Hospital, No. 100 Xi Si Huan Middle Road, Fengtai District, Beijing 100039, China. ORCID: Tel: +86-13621386161, E-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2021;9(5):672-681 DOI: 10.14218/JCTH.2020.00188
Received:December 30, 2020 Accepted:April 5, 2021 Published online:April 28, 2021


Background and Aims:There are no comparative studies on the efficacy of hepatic resection (HR) and CyberKnife stereotactic body radiation therapy (CK-SBRT) plus transhepatic arterial chemotherapy embolization (TACE) in the treatment of large hepatocellular carcinoma (HCC). Therefore, this study aimed to compare the efficacy of HR and CK-SBRT+TACE in large HCC.

Methods:A total of one hundred and sixteen patients were selected from November 2011 to December 2016. Among them, 50 were allocated to the CK-SBRT+TACE group and 66 were allocated to the HR group. The Kaplan-Meier method was applied to calculate overall survival (OS) and progression-free survival (PFS) rates. Propensity score matching was performed to control for baseline differences between the groups.

Results:Thirty-six paired patients were selected from the CK-SBRT+TACE and HR groups. After propensity score matching, the 1-, 2- and 3-year OS rates were 83.3%, 77.8% and 66.7% in the HR group and 80.6%, 72.2% and 52.8% in the CK-SBRT+TACE group, respectively. The 1-, 2- and 3-year PFS rates were 71.6%, 57.3% and 42.3% in the HR group and 66.1%, 45.8% and 39.3% in the CK-SBRT+TACE group, respectively (OS: p=0.143; PFS: p=0.445). Both a high platelet count and low alpha-fetoprotein value were revealed as influencing factors in improving OS and PFS.

Conclusions:CK-SBRT+TACE brought local effects that were similar to those of HR in HCC patients with a large and single lesion. Moreover, the liver injury occurrence rate was acceptable in both groups.


CyberKnife, Radiation-induced liver disease, Survival rates, Large hepatocellular carcinoma

Journal of Clinical and Translational Hepatology 2021 vol. 9, 672-681  [ Html  ] [ PDF Full-text ]

© 2021 Authors. This is an Open Access article distributed under the terms of the  Creative Commons Attribution-Noncommercial 4.0 License(CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


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