title: Clinical Benefit of Hepatic Arterial Infusion Concurrent Chemoradiotherapy in Locally Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis.
abstract: The aim of this study was to evaluate whether hepatic arterial infusion concurrent chemoradiotherapy (CCRT) could improve overall survival (OS) in patients with locally advanced hepatocellular carcinoma (LAHCC).
  
  
  
  Two databases were reviewed from Yonsei Cancer Center (YCC) and Korean Liver Cancer Study Group (KLCSG) nationwide multi-center hepatocellular carcinoma (HCC) cohort. The CCRT group included 106 patients, with stage III-IV, Child-Pugh classification A, Eastern Cooperative Oncology Group performance status 0 or 1, who underwent definitive CCRT as the initial treatment at YCC. We used propensity score matching to adjust for seven clinical factors, including age, tumor size, TNM stage by the Liver Cancer Study Group of Japan, T stage, Barcelona Clinic Liver Cancer (BCLC) staging system, etiology of HCC, and portal vein invasion, which all differed significantly in the two databases. From the KLCSG cohort enrolled at 32 institutions, 106 patients for the non-CCRT group were defined.
  
  
  
  After propensity score matching, all patient characteristics were balanced between the two groups. The CCRT group had better OS (median, 11.4) than the non-CCRT group (6.6 months, p=0.02). In multivariate analyses for all patients, CCRT (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.11 to 1.97; p=0.007), tumor size (HR, 1.08; 95% CI, 1.04 to 1.12; p < 0.001), and BCLC stage (HR, 0.54; 95% CI, 0.36 to 0.8; p=0.003) were independent prognostic factors for OS.
  
  
  
  CCRT showed better OS for LAHCC patients. In LAHCC patients with a good performance and normal liver function, CCRT could be a feasible treatment option. All of these findings need to be validated in prospective clinical trials.
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea ; Department of Pharmacology, Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hong In
authors.initials: HI
authors.lastname: Yoon
authors.affiliation: Department of Biostatics, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ki Jun
authors.initials: KJ
authors.lastname: Song
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea ; Yonsei Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea ; Korean Liver Cancer Study Group, Seoul, Korea.
authors.forename: Ik Jae
authors.initials: IJ
authors.lastname: Lee
authors.affiliation: Yonsei Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea ; Korean Liver Cancer Study Group, Seoul, Korea ; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Yonsei Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea ; Korean Liver Cancer Study Group, Seoul, Korea ; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea ; Yonsei Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea ; Korean Liver Cancer Study Group, Seoul, Korea.
authors.forename: Jinsil
authors.initials: J
authors.lastname: Seong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D059248:Chemoradiotherapy; D002648:Child; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D057216:Propensity Score; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hepatocellular carcinoma; Propensity score; Radiotherapy