Long‐Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma

ABSTRACT Background/Aims This study presents a detailed analysis of long‐term survival and critical factors influencing the outcomes of hepatocellular carcinoma patients treated with stereotactic body radiotherapy (SBRT) and transarterial chemoembolization (TACE). Our findings provide reassurance ab...

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Main Authors: Hoang Dong Duc, Mai Binh Thanh, Mai Bang Hong, Nguyen Thinh Tien, Nguyen Thai Van, Bui Bieu Quang, Nguyen Chau Dinh, Thai Ky Doan
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Cancer Reports
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Online Access:https://doi.org/10.1002/cnr2.70212
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author Hoang Dong Duc
Mai Binh Thanh
Mai Bang Hong
Nguyen Thinh Tien
Nguyen Thai Van
Bui Bieu Quang
Nguyen Chau Dinh
Thai Ky Doan
author_facet Hoang Dong Duc
Mai Binh Thanh
Mai Bang Hong
Nguyen Thinh Tien
Nguyen Thai Van
Bui Bieu Quang
Nguyen Chau Dinh
Thai Ky Doan
author_sort Hoang Dong Duc
collection DOAJ
description ABSTRACT Background/Aims This study presents a detailed analysis of long‐term survival and critical factors influencing the outcomes of hepatocellular carcinoma patients treated with stereotactic body radiotherapy (SBRT) and transarterial chemoembolization (TACE). Our findings provide reassurance about the potential of the combination of TACE and SBRT as an effective treatment strategy for patients with large liver tumors due to HCC. Methods A prospective study was conducted on 42 patients with intermediate‐stage hepatocellular carcinoma (HCC) at 108 Military Central Hospital between December 2018 and June 2024. Following a single session of TACE, each patient underwent SBRT 1 month later. The SBRT dose ranged from 27.5 to 48 Gy, delivered in 3–5 fractions. The patient survival analysis was conducted using the Kaplan–Meier method while examining prognostic factors influencing survival, which involved log‐rank tests and Cox proportional hazards regression analysis. Results Among the 42 patients (83.3% male), 34 patients (81.0%) had tumors measuring ≥ 5 cm. The median follow‐up period was 32.2 months (4.5–65.1 months). The median overall survival (OS) was 32.6 months, with the respective 1‐, 3‐, and 5‐year OS rates reported as 73.8%, 24.5%, and 19.6%. Furthermore, the median progression‐free survival (PFS) was 16.6 months, with corresponding 1‐ and 3‐year PFS rates of 71.4% and 19.0%. Factors linked to improved OS and PFS included AFP levels and treatment response based on Modified RECIST criteria. Additionally, multivariate analysis identified patient age, EQD2, and BED10 as significant predictors of better survival outcomes. Conclusions Our study provides evidence supporting the effectiveness and safety of combining TACE and SBRT as a treatment strategy for patients with large liver tumors due to HCC, instilling confidence in the future of HCC treatment. Positive prognostic factors included patient age, EQD2, and BED10.
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spelling doaj-art-62bc4b82e59a4f769f46a51c5dc08c652025-08-20T03:05:27ZengWileyCancer Reports2573-83482025-05-0185n/an/a10.1002/cnr2.70212Long‐Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular CarcinomaHoang Dong Duc0Mai Binh Thanh1Mai Bang Hong2Nguyen Thinh Tien3Nguyen Thai Van4Bui Bieu Quang5Nguyen Chau Dinh6Thai Ky Doan7Department of Internal Medicine Thai Nguyen University of Medicine and Pharmacy Thai Nguyen VietnamDepartment of Gastroenterology and Hepatology 108 Military Central Hospital Hanoi VietnamDepartment of Gastroenterology and Hepatology 108 Military Central Hospital Hanoi VietnamDepartment of Gastroenterology and Hepatology 108 Military Central Hospital Hanoi VietnamDepartment of Gastroenterology and Hepatology 108 Military Central Hospital Hanoi VietnamDepartment of Radiation Oncology and Radiosurgery 108 Military Central Hospital Hanoi VietnamDepartment of Radiation Oncology and Radiosurgery 108 Military Central Hospital Hanoi VietnamDepartment of Gastroenterology and Hepatology 108 Military Central Hospital Hanoi VietnamABSTRACT Background/Aims This study presents a detailed analysis of long‐term survival and critical factors influencing the outcomes of hepatocellular carcinoma patients treated with stereotactic body radiotherapy (SBRT) and transarterial chemoembolization (TACE). Our findings provide reassurance about the potential of the combination of TACE and SBRT as an effective treatment strategy for patients with large liver tumors due to HCC. Methods A prospective study was conducted on 42 patients with intermediate‐stage hepatocellular carcinoma (HCC) at 108 Military Central Hospital between December 2018 and June 2024. Following a single session of TACE, each patient underwent SBRT 1 month later. The SBRT dose ranged from 27.5 to 48 Gy, delivered in 3–5 fractions. The patient survival analysis was conducted using the Kaplan–Meier method while examining prognostic factors influencing survival, which involved log‐rank tests and Cox proportional hazards regression analysis. Results Among the 42 patients (83.3% male), 34 patients (81.0%) had tumors measuring ≥ 5 cm. The median follow‐up period was 32.2 months (4.5–65.1 months). The median overall survival (OS) was 32.6 months, with the respective 1‐, 3‐, and 5‐year OS rates reported as 73.8%, 24.5%, and 19.6%. Furthermore, the median progression‐free survival (PFS) was 16.6 months, with corresponding 1‐ and 3‐year PFS rates of 71.4% and 19.0%. Factors linked to improved OS and PFS included AFP levels and treatment response based on Modified RECIST criteria. Additionally, multivariate analysis identified patient age, EQD2, and BED10 as significant predictors of better survival outcomes. Conclusions Our study provides evidence supporting the effectiveness and safety of combining TACE and SBRT as a treatment strategy for patients with large liver tumors due to HCC, instilling confidence in the future of HCC treatment. Positive prognostic factors included patient age, EQD2, and BED10.https://doi.org/10.1002/cnr2.70212hepatocellular carcinomastereotactic body radiotherapytransarterial chemoembolization
spellingShingle Hoang Dong Duc
Mai Binh Thanh
Mai Bang Hong
Nguyen Thinh Tien
Nguyen Thai Van
Bui Bieu Quang
Nguyen Chau Dinh
Thai Ky Doan
Long‐Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma
Cancer Reports
hepatocellular carcinoma
stereotactic body radiotherapy
transarterial chemoembolization
title Long‐Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma
title_full Long‐Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma
title_fullStr Long‐Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma
title_full_unstemmed Long‐Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma
title_short Long‐Term Survival and Prognostic Factors of Stereotactic Body Radiotherapy Following Transarterial Chemoembolization for Hepatocellular Carcinoma
title_sort long term survival and prognostic factors of stereotactic body radiotherapy following transarterial chemoembolization for hepatocellular carcinoma
topic hepatocellular carcinoma
stereotactic body radiotherapy
transarterial chemoembolization
url https://doi.org/10.1002/cnr2.70212
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