Survival benefit with IMRT following narrow-margin hepatectomy in patients with hepatocellular carcinoma close to major vessels
Background & Aims: To investigate the role of post-operative intensity-modulated radiotherapy (IMRT) in patients receiving narrow-margin hepatectomy for hepatocellular carcinoma (HCC) located close to the major vessels.Methods: This exploratory study involved 181 HCC patients.Of them, 116 were treated with narrow-margin (<1.0 cm) hepatectomy.Thirty-three of the 116 underwent postoperative IMRT (Group A), while 83 did not receive radiotherapy (Group B).The remaining 65 patients underwent wide-margin (≥1.0 cm) hepatectomy (Group C).Prognosis and patterns of recurrence were assessed in the three groups.Results: The 3-year overall survival (OS) and disease-free survival (DFS) rates were 89.1 and 64.2% in Group A, 67.7 and 52.2% in Group B and 86.0 and 60.1% in Group C respectively.The OS and DFS of Group A and Group C patients surpassed those of Group B patients (Group A vs.B, P =0.009 and P =0.038;and Group C vs.B, P =0.002 and P =0.010).Patients in Groups A and C experienced significantly fewer early recurrences than did patients in Group B (P =0.002).Furthermore, patients in Groups A and C experienced substantially fewer intrahepatic marginal (P=0.048) and diffuse recurrences (P =0.018) and extrahepatic metastases (P =0.038) than did patients in Group B.No patient developed radiation-induced liver disease.Conclusions: Post-operative IMRT following narrow-margin hepatectomy may be a favourable therapy for both its safety profile and clinical benefit in patients with HCC located close to the major vessels.
hepatocellular carcinoma patterns of recurrence postoperative radiotherapy prognosis
Wei-Hu Wang Zhi Wang Jian-Xiong Wu Tao Zhang Wei-Qi Rong Li-Ming Wang Jing Jin Shu-Lian Wang Yong-Wen Song Yue-Ping Liu Hua Ren Hui Fang Wen-Qing Wang Xin-Fan Liu Zi-Hao Yu Ye-Xiong Li
Department of Radiation Oncology,Cancer Hospital and Institute,Chinese Academy of Medical Sciences ( Department of Abdominal Surgery,Cancer Hospital and Institute,Chinese Academy of Medical Sciences (C
国内会议
北京
英文
494-501
2016-01-09（万方平台首次上网日期，不代表论文的发表时间）