The impact of TBS and post-radiotherapy AFP stabilization time on prognosis in HCC patients complicated with PVTT
10.3760/cma.j.cn113030-20230922-00099
- VernacularTitle:TBS和放疗后AFP稳定时间对肝细胞癌合并PVTT患者预后的影响
- Author:
Abulimiti MUNIRE
1
;
Yajie CHEN
;
Xushan TANG
;
Yao TAN
;
Yong TANG
Author Information
1. 新疆医科大学附属肿瘤医院消化内科，乌鲁木齐 830011
- Keywords:
Carcinoma, hepatocellular;
Portal vein thrombosis;
Alpha-fetoprotein;
Tumor burden score
- From:
Chinese Journal of Radiation Oncology
2024;33(8):719-725
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of tumor burden score (TBS) and post-radiotherapy alpha-fetoprotein (AFP) stabilization time on the prognosis of hepatocellular carcinoma (HCC) patients complicated with portal vein tumor thrombus (PVTT).Methods:Clinical data of 40 eligible HCC patients complicated with PVTT admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from July 2018 to March 2022 were retrospectively analyzed. The objective response rate (ORR), overall survival (OS), progression-free survival (PFS), AFP response, and post-radiotherapy AFP stabilization time in the entire group were observed. Diagnostic thresholds were determined by the receiver operating characteristic (ROC) curve. Survival analysis was conducted by Kaplan-Meier method, and the differences of survival rate were assessed by log-rank test. Multivariate analysis was performed by Cox proportional risk model.Results:The optimal cut-off value for TBS was 4.27 [area under the ROC curve (AUC)=0.752, P=0.018]. The ORR in the entire group was 35.7%, with a median OS and PFS of 8 and 5 months, respectively. The median AFP stabilization time was 6 months. Univariate analysis showed that a total of 9 factors were associated with OS, including gender, maximum tumor diameter, TBS, China liver cancer staging, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, gamma-glutamyl transferase (GGT), radiation dose, AFP stabilization time, and tumor response. Multivariate analysis showed that TBS>4.27 ( HR=0.195, 95% CI=0.060-0.638, P=0.007), China liver cancer stage Ⅲb staging ( HR=0.328, 95% CI=0.144-0.745, P=0.008), and AFP stabilization time ≤6 months ( HR=10.282, 95% CI=2.304-45.883, P=0.002) were the independent risk factors for OS in HCC patients complicated with PVTT. Conclusion:HCC patients complicated with PVTT who have low TBS and AFP stabilization time after radiotherapy may obtain longer OS, and the combination of TBS and AFP is expected to become a new risk assessment model.
