Chinese researchers from Eastern Hepatobiliary Surgery Hospital, Navy Military Medical University, Shanghai showed that neoadjuvant 3D conformal radiotherapy provided significantly better post-surgery survival outcomes than surgery alone in patients with resectable hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT), as evidenced from a recent clinical trial.
The multi-center study in China included a total of 164 patients who were enrolled in the controlled study between January 2016 and December 2017, reports Hina Porcelli from the Oncology Learning Network. Patients were randomized to receive neoadjuvant radiotherapy followed by hepatectomy (n=82) or hepatectomy alone (n=82). The primary study end point was overall survival (OS).
Overall, 20.7% of the patients with partial remissions were in the neoadjuvant radiotherapy arm. The OS rates were 89.9%, 72.5%, 43.9% and 27.4% in the neoadjuvant radiotherapy arm at 6,12,18 and 24 months, respectively, versus 81.7%, 43.1%, 16.7% and 9.4% in the arm that received surgery alone (P<.001). Findings also demonstrated disease-free survival rates of 56.9%, 33.0%, 20.3% and 13.3% versus 42.1%, 14.9%, 5.0% and 3.3% for each arm, respectively (p<.001).
Multivariable Cox regression analyses yielded significantly reduced HCC-related mortality and HCC recurrence rates with neoadjuvant radiotherapy versus surgery alone.
Xubiao Wei, MD, Eastern Hepatobiliary Surgery Hospital, Navy Military Medical University, Shanghai, People’s Republic of China