Abstract
Purpose
Lack of evidence on the benefit of stereotactic body radiotherapy (SBRT) in combination with lenvatinib for advanced hepatocellular carcinoma (HCC). Our research compared the efficacy and safety of SBRT plus lenvatinib versus SBRT alone in clinical practice for the treatment of advanced HCC.
Methods
Propensity score matching (PSM) analysis was used to reduce selection bias. Overall survival (OS), progression-free survival (PFS), intrahepatic PFS (IHPFS), and objective response rate (ORR) were compared between the two groups. Additionally, safety profiles were also evaluated in the two groups.
Results
After PSM, 35 patients from each group were selected and the date was compared. Compared with the SBRT alone group, the median OS, PFS, and IHPFS were significantly prolonged in SBRT plus lenvatinib group (median OS 16.8 vs. 11.0 months, pOS = 0.043; median PFS 9.1 vs. 3.7 months, pPFS < 0.001; median IHPFS 9.5 vs. 4.2 months, pIHPFS = 0.004). The 6- and 12-month OS rates were 91.4% and 68.6% in the combined therapy group and 82.9% and 48.6% in the monotherapy group, respectively. The 6- and 12-month PFS rates were 68.6% and 34.3% in the combined therapy group and 31.4% and 8.6% in the monotherapy group, respectively. Furthermore, a higher ORR was observed in SBRT plus lenvatinib group (54.29% vs. 22.86%, p = 0.007). Subgroup analysis of patients with macroscopic vascular invasion (MVI) also had similar results. Moreover, most adverse events (AEs) were mild-to-moderate and manageable in the SBRT plus lenvatinib group.
Conclusion
SBRT plus lenvatinib is expected to significantly improve OS, PFS, IHPFS, and ORR for patients with advanced HCC when compared to SBRT alone, with manageable adverse effects.
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Data Availability
The data sets analysed during the current study are available from the corresponding author on reasonable request.
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This research was funded by National Natural Science Foundation of China, grant number 82003211.
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Data analysis and interpretation, and drafting and revision of the manuscript for critically important intellectual content (QW, XQJ, JS, WGL), data acquisition (XQJ, WQ, WGL), manuscript preparation (QW, XQJ, JS, XZD, AMZ), and provision of final approval of the version to be published (XZD, AMZ). All authors have read and approved the final version.
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Wang, Q., Ji, X., Sun, J. et al. Comparison of stereotactic body radiotherapy with and without lenvatinib for advanced hepatocellular carcinoma: a propensity score analysis. J Cancer Res Clin Oncol 149, 7441–7452 (2023). https://doi.org/10.1007/s00432-023-04652-y
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DOI: https://doi.org/10.1007/s00432-023-04652-y