CT-guided high-dose-rate brachytherapy versus transarterial chemoembolization in patients with unresectable hepatocellular carcinoma

• Verfasst von: Auer, Timo Alexander [VerfasserIn]
• Verfasst von: Müller, Lukas [VerfasserIn]
• Verfasst von: Schulze, Daniel [VerfasserIn]
• Verfasst von: Anhamm, Melina [VerfasserIn]
• Verfasst von: Bettinger, Dominik [VerfasserIn]
• Verfasst von: Wagner, Verena [VerfasserIn]
• Verfasst von: Haubold, Johannes [VerfasserIn]
• Verfasst von: Zopfs, David [VerfasserIn]
• Verfasst von: Pinto dos Santos, Daniel [VerfasserIn]
• Verfasst von: Eisenblätter, Michel [VerfasserIn]
• Verfasst von: Gebauer, Bernhard [VerfasserIn]
• Verfasst von: Kloeckner, Roman [VerfasserIn]
• Verfasst von: Collettini, Federico [VerfasserIn]
• Titel: CT-guided high-dose-rate brachytherapy versus transarterial chemoembolization in patients with unresectable hepatocellular carcinoma
• Verf.angabe: Timo A. Auer, MD, Lukas Müller, MD, PhD, Daniel Schulze, MS, PhD, Melina Anhamm, Dominik Bettinger, MD, Verena Steinle, MD, Johannes Haubold, MD, David Zopfs, MD, Daniel Pinto dos Santos, MD, Michel Eisenblätter, MD, PhD, Bernhard Gebauer, MD, Roman Kloeckner, MD, Federico Collettini, MD
• E-Jahr: 2024
• Jahr: February 2024
• Umfang: 9 S.
• Illustrationen: Illustrationen
• Fussnoten: Online veröffentlicht: 6. Februar 2024 ; Gesehen am 25.02.2025
• Titel Quelle: Enthalten in: Radiology
• Ort Quelle: Oak Brook, Ill. : Soc., 1923
• Jahr Quelle: 2024
• Band/Heft Quelle: 310(2024), 2 vom: Feb., Artikel-ID e232044, Seite 1-9
• ISSN Quelle: 1527-1315
• DOI: doi:10.1148/radiol.232044
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1918503699

Abstract

Background - - CT-guided high-dose-rate (HDR) brachytherapy (hereafter, HDR brachytherapy) has been shown to be safe and effective for patients with unresectable hepatocellular carcinoma (HCC), but studies comparing this therapy with other local-regional therapies are scarce. - - Purpose - - To compare patient outcomes of HDR brachytherapy and transarterial chemoembolization (TACE) in patients with unresectable HCC. - - Materials and Methods - - This multi-institutional retrospective study included consecutive treatment-naive adult patients with unresectable HCC who underwent either HDR brachytherapy or TACE between January 2010 and December 2022. Overall survival (OS) and progression-free survival (PFS) were compared between patients matched for clinical and tumor characteristics by propensity score matching. Not all patients who underwent TACE had PFS available; thus, a different set of patients was used for PFS and OS analysis for this treatment. Hazard ratios (HRs) were calculated from Kaplan-Meier survival curves. - - Results - - After propensity matching, 150 patients who underwent HDR brachytherapy (median age, 71 years [IQR, 63-77 years]; 117 males) and 150 patients who underwent TACE (OS analysis median age, 70 years [IQR, 63-77 years]; 119 male; PFS analysis median age, 68 years [IQR: 63-76 years]; 119 male) were analyzed. Hazard of death was higher in the TACE versus HDR brachytherapy group (HR, 4.04; P < .001). Median estimated PFS was 32.8 months (95% CI: 12.5, 58.7) in the HDR brachytherapy group and 11.6 months (95% CI: 4.9, 22.7) in the TACE group. Hazard of disease progression was higher in the TACE versus HDR brachytherapy group (HR, 2.23; P < .001). - - Conclusion - - In selected treatment-naive patients with unresectable HCC, treatment with CT-guided HDR brachytherapy led to improved OS and PFS compared with TACE.