Purpose: Evidence is lacking concerning the benefit of the combination of sorafenib and radiotherapy to treat advanced hepatocellular carcinoma (HCC). To date, no publication has reported the outcomes of radiotherapy alone versus concurrent therapy. We aimed to compare the effectiveness of radiotherapy alone versus concurrent radiotherapy and sorafenib for locally advanced hepatocellular carcinoma.
Materials and Methods: We conducted a propensity score matching (PSM) cohort study comparing the effectiveness of the concurrent use of sorafenib and external beam radiotherapy versus radiotherapy alone in Barcelona Clinic Liver Cancer (BCLC) stage B or C, nonsurgically managed, nonmetastatic patients with HCC. Two subpopulations were matched based on baseline characteristics. Stratified analysis was also performed to assess the heterogeneous effects of the two arms. Overall survival (OS) was compared. Radiation-induced liver disease (RILD) and overt gastrointestinal (GI) bleeding events were also recorded.
Results: Seven hundred thirty-one BCLC stage B or C nonmetastatic HCC patients were identified from 2007 to 2017. Of these, 347 patients met the inclusion criteria (Radiotherapy alone: 269 patients; concurrent therapy: 78 patients). Propensity score matching yielded 73 patients each in the radiotherapy and concurrent groups. The median OS was 9.6 months in the radiotherapy-alone group and 9.9 months in the concurrent group (hazard ratio (HR): 1.12; 95% CI=0.78– 1.62; p=0.544). Posttreatment toxicities, including radiation-induced liver disease and overt gastrointestinal bleeding, showed no significant differences between the groups.
Conclusion: In our study, the concurrent use of sorafenib and conventional external beam radiotherapy shows no survival benefit over radiotherapy alone for locally advanced hepatocellular carcinoma.

Keywords: radiotherapy, sorafenib, hepatocellular carcinoma


中文翻译：

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索拉非尼联合放疗与单独放疗治疗局部晚期肝细胞癌：倾向匹配分析

目的：缺乏证据表明索拉非尼联合放疗治疗晚期肝细胞癌 (HCC) 的益处。迄今为止，没有出版物报道单独放疗与同步治疗的结果。我们旨在比较单独放疗与同步放疗和索拉非尼治疗局部晚期肝细胞癌的疗效。
材料和方法：我们进行了一项倾向评分匹配 (PSM) 队列研究，比较了在巴塞罗那临床肝癌 (BCLC) B 期或 C 期、非手术治疗、非转移性 HCC 患者中同时使用索拉非尼和外照射放疗与单独放疗的有效性。根据基线特征匹配两个亚群。还进行了分层分析以评估两组的异质效应。比较总生存期（OS）。还记录了辐射诱发的肝病 (RILD) 和明显的胃肠道 (GI) 出血事件。
结果：从 2007 年到 2017 年，共确定了 731 名 BCLC B 或 C 期非转移性 HCC 患者。其中，347 名患者符合纳入标准（单纯放疗：269 名患者；同时治疗：78 名患者）。倾向评分匹配在放疗组和并发组中各产生 73 名患者。单独放疗组的中位 OS 为 9.6 个月，同时放疗组为 9.9 个月（风险比 (HR)：1.12；95% CI=0.78–1.62；p =0.544）。治疗后毒性，包括辐射诱发的肝病和明显的胃肠道出血，两组之间没有显着差异。
结论：在我们的研究中，同时使用索拉非尼和常规外照射放疗显示，局部晚期肝细胞癌与单独放疗相比没有生存获益。

关键词：放疗，索拉非尼，肝细胞癌