文章：

比较定量反应评估工具与LIRADS治疗反应算法在肝细胞癌患者接受间质高剂量率近距离放疗和常规经动脉化疗栓塞术后的预后价值

Comparing the Prognostic Value of Quantitative Response Assessment Tools and LIRADS Treatment Response Algorithm in Patients with Hepatocellular Carcinoma Following Interstitial High-Dose-Rate Brachytherapy and Conventional Transarterial Chemoembolization

原文发布日期：9 April 2025

DOI: 10.3390/cancers17081275

类型: Article

开放获取: 是

英文摘要：

Background/Objectives:The aim of this study was to investigate the prognostic value of established response assessment tools for hepatocellular carcinoma (HCC) treated with high-dose-rate interstitial brachytherapy (iBT) alone or with transarterial chemoembolization (cTACE).Methods:(Non-)responders were categorized using size-based RECIST 1.1 and WHO criteria, enhancement-based mRECIST and EASL criteria, and the LI-RADS Treatment Response Algorithm (LR-TRA). The outcomes were the overall survival (OS), progression-free survival (PFS), and time to progression (TTP). The statistics used included Fisher’s exact test, at-test, the Mann–Whitney-U test, and a Kaplan–Meier analysis. The median OS, PFS, and TTP were higher in patients following iBT (26.3, 9.1, and 13.0 months) than following cTACE/iBT (23.3, 7.6, and 9.2 months).Results:The enhancement-based criteria identified more responders and predicted PFS and TTP better compared to the size-based criteria. At two months, the cTACE/iBT responders showed improved PFS (mRECIST and EASL: 11.3 vs. 2.3 and 11.0 vs. 2.3,p< 0.01) and TTP (mRECIST and EASL: 11.9 vs. 2.4 months,p< 0.01) by the enhancement-based criteria. An EASL assessment at five months predicted improved survival following both cTACE/iBT (PFS: 11.9 vs. 5.1 months,p= 0.03; TTP: 12.4 vs. 5.0,p< 0.01) and iBT (11.1 vs. 5.1 months,p= 0.04; 13.0 vs. 5.3,p< 0.01). The LR-TRA showed OS benefits at five months for cTACE/iBT responders. Size-based criteria were not prognostic.Conclusions:Extending follow-up post-iBT or post-iBT/cTACE may improve responder stratification and prognostication.

摘要翻译： 

背景/目的：本研究旨在探讨现有疗效评估工具对单独采用高剂量率组织间近距离放疗（iBT）或联合经动脉化疗栓塞（cTACE）治疗的肝细胞癌（HCC）的预后价值。方法：采用基于大小的RECIST 1.1和WHO标准、基于强化的mRECIST和EASL标准以及LI-RADS治疗反应算法（LR-TRA）对（非）应答者进行分类。观察指标包括总生存期（OS）、无进展生存期（PFS）和疾病进展时间（TTP）。统计方法采用Fisher精确检验、t检验、Mann-Whitney U检验和Kaplan-Meier分析。结果显示，iBT治疗患者的中位OS、PFS和TTP（分别为26.3、9.1和13.0个月）均高于cTACE/iBT联合治疗患者（23.3、7.6和9.2个月）。结果：与基于大小的标准相比，基于强化的标准能识别更多应答者，并更准确地预测PFS和TTP。在两个月评估时，基于强化标准显示cTACE/iBT应答者的PFS（mRECIST和EASL：11.3 vs. 2.3及11.0 vs. 2.3个月，p<0.01）和TTP（mRECIST和EASL：11.9 vs. 2.4个月，p<0.01）均显著改善。五个月时的EASL评估可预测cTACE/iBT（PFS：11.9 vs. 5.1个月，p=0.03；TTP：12.4 vs. 5.0个月，p<0.01）和iBT（PFS：11.1 vs. 5.1个月，p=0.04；TTP：13.0 vs. 5.3个月，p<0.01）治疗后的生存改善。LR-TRA在五个月时显示cTACE/iBT应答者具有OS获益。基于大小的标准无预后预测价值。结论：延长iBT或iBT/cTACE联合治疗后的随访时间可能改善应答者分层和预后评估。

原文链接：

Comparing the Prognostic Value of Quantitative Response Assessment Tools and LIRADS Treatment Response Algorithm in Patients with Hepatocellular Carcinoma Following Interstitial High-Dose-Rate Brachytherapy and Conventional Transarterial Chemoembolization