■质子束疗法(PBT)已知是肝细胞癌(HCC)的有效局部治疗。然而,很少有关于初治病例的比较研究报道。这项研究的目的是比较PBT与射频消融(RFA)在未治疗的孤立性HCC患者中的生存结果。
■95例连续接受初治肝癌的患者,直径≤5厘米的单个结节,在2001年至2013年期间在筑波大学医院接受PBT治疗的Child-Pugh评分≤8的患者被纳入研究.此外,同期在东京大学医院接受RFA治疗的836例原发性肝癌患者作为对照进行分析。在倾向评分匹配后,比较了83例患者的无复发生存率(RFS)和总生存率(OS)。
■1年,3年,5年RFS率为86.6%,49.5%,和35.5%,分别,在PBT组中,59.5%,34.0%,RFA组为20.9%(p=0.058);各自的OS率为97.6%,77.8%,PBT组的57.1%和95.1%,81.7%,RFA组为67.7%(p=0.16)。关于不利影响,在PBT中未发现3级或更高的不良事件;然而,RFA组在RFA治疗后30天内发生了2起3级不良事件:1起腹膜积血和1起胸积血.
■倾向得分匹配后,与RFA相比,PBT在RFS和OS方面没有显着差异。PBT可以作为单独治疗初治HCC患者的替代方案。
UNASSIGNED: Proton beam therapy (PBT) is known to be an effective locoregional treatment for hepatocellular carcinoma (HCC). However, few comparative studies in treatment-naïve cases have been reported. The aim of this study was to compare the survival outcomes of PBT with those of radiofrequency ablation (RFA) in patients with treatment-naïve solitary HCC.
UNASSIGNED: Ninety-five consecutive patients with treatment-naïve HCC, a single nodule measuring ≤5 cm in diameter, and a Child-Pugh score of ≤8 who were treated with PBT at the University of Tsukuba Hospital between 2001 and 2013 were enrolled in the study. In addition, 836 patients with treatment-naïve HCC treated by RFA at the University of Tokyo Hospital during the same period were analyzed as controls. Recurrence-free survival (RFS) and overall survival (OS) were compared in 83 patient pairs after propensity score matching.
UNASSIGNED: The 1-year, 3-year, and 5-year RFS rates were 86.6%, 49.5%, and 35.5%, respectively, in the PBT group and 59.5%, 34.0%, and 20.9% in the RFA group (p = 0.058); the respective OS rates were 97.6%, 77.8%, and 57.1% in the PBT group and 95.1%, 81.7%, and 67.7% in the RFA group (p = 0.16). Regarding adverse effects, no grade 3 or higher adverse events were noted in the PBT; however, two grade 3 adverse events occurred within 30 days of RFA in the RFA group: one hemoperitoneum and one hemothorax.
UNASSIGNED: After propensity score matching, PBT showed no significant difference in RFS and OS compared to RFA. PBT can be an alternative for patients with solitary treatment-naïve HCC.