METHODS: A total of 220 patients with HCC treated with either transarterial (n = 121) or systemic treatments (n = 99; mainly Sorafenib) were retrospectively analyzed. The GALAD score and the BALAD-2 score were calculated based on AFP-L3, AFP, and DCP levels measured in serum samples collected before treatment. The results were correlated with 3-month treatment efficacy based on radiologic mRECIST criteria.
RESULTS: The GALAD score showed a strong correlation with BCLC stage (p < 0.001) and total tumor diameter before treatment (p < 0.001).The GALAD score at baseline was significantly lower in patients with a 3-month response to transarterial (p > 0.001) than in refractory patients. Among patients receiving systemic treatment, the median BALAD-2 score at baseline showed a strong association with response at month 3 (p < 0.001). In the transarterial treatment group, the GALAD score (AUC = 0.715; p < 0.001) as well as the BALAD score (AUC = 0.696; p < 0.001) were associated with overall survival, hereby outperforming AFP, AFP-L3 and DCP.
CONCLUSIONS: The GALAD score as well as the BALAD-2 score hold significant promise as a prognostic tool for patients with early or intermediate-stage HCC who are undergoing transarterial or systemic treatments.
方法:回顾性分析了220例经动脉(n=121)或全身治疗(n=99;主要是索拉非尼)的HCC患者。根据AFP-L3、AFP、和在治疗前收集的血清样品中测量的DCP水平。根据放射学mRECIST标准,结果与3个月的治疗效果相关。
结果:GALAD评分与治疗前的BCLC分期(p<0.001)和肿瘤总直径(p<0.001)有很强的相关性。基线时的GALAD评分在对动脉有3个月反应的患者中显著低于难治性患者(p>0.001)。在接受全身治疗的患者中,基线时的中位BALAD-2评分与第3个月时的缓解率密切相关(p<0.001).在经动脉治疗组中,GALAD评分(AUC=0.715;p<0.001)和BALAD评分(AUC=0.696;p<0.001)与总生存率相关,因此表现优于法新社,AFP-L3和DCP。
结论:GALAD评分和BALAD-2评分作为早期或中期HCC患者经动脉或全身治疗的预后工具具有重要意义。