Prospective Study of Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma on Waitlist for Liver Transplant

• DOI: 10.1002/hep.31992
• Publication Date: 2021-06-06T18:25:16Z
• Authors: Tiffany Cho‐Lam Wong; Victor Ho‐Fun Lee; Ada Lai‐Yau Law; Herbert H. Pang; Ka‐On Lam; Vince Lau; Tracy Yushi Cui; Adrianna Sze‐Yin ...; Sarah Wai‐Man Lee; Edwin Chun‐Yin Wong; Jeff Wing‐Chiu Dai; Albert Chi‐Yan Chan; Tan‐To Cheung; James Yan‐Yue Fung; Rebecca Mei‐Wan Y...; Mai‐Yee Luk; To‐Wai Leung; Chung‐Mau Lo
• Keywords: Cumulative incidence; Clinical endpoint

Background and Aims There are no prospective data on stereotactic body radiation therapy (SBRT) as a bridge to liver transplantation for HCC. This study aimed evaluate the efficacy safety of SBRT bridging therapy, with comparison transarterial chemoembolization (TACE) high‐intensity focused ultrasound (HIFU). Approach Results Patients were prospectively enrolled under standardized protocol from July 2015 compared retrospective cohort patients who underwent TACE or HIFU 2010. The primary endpoint was tumor control rate at 1 year after therapy. Secondary endpoints included cumulative incidence dropout, toxicity, posttransplant survival. During period, 150 evaluated (SBRT, n = 40; TACE, 59; HIFU, 51). significantly higher (92.3%, 43.5%, 33.3%, respectively; P 0.02). With competing risk analysis, dropout 3 years listing lower (15.1% 23.3%) (28.9% 45.8%; 0.034) (33.3% 45.1%; 0.032). Time‐to‐progression also superior (10.8%, 18.5% in SBRT, 45%, 54.9% 47.6%, 62.8% HIFU; < 0.001). periprocedural toxicity similar, without any difference perioperative complications patient recurrence‐free survival rates transplant. Pathological complete response more frequent (48.1% vs. 25% 17.9%, 0.037). In multivariable size <3 cm, alpha‐fetoprotein <200 ng/mL, Child A, reduced dropout. Conclusions safe, rate, waitlist should be used an alternative conventional therapies.