title: The effect of radiotherapy in liver-confined but non-resectable Barcelona Clinic Liver Cancer stage C large hepatocellular carcinoma.
abstract: OBJECTIVE
  Clinical trials to determine the efficacy of radiotherapy (RT) in liver-confined but non-resectable Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) are scarce. We aimed to determine the benefit of RT in such tumors and investigated large HCC tumors.
  
  
  METHODS
  HCC data from the Korea Central Cancer Registry recorded from 2008 to 2010 were used. A total of 593 patients met our inclusion criteria; 67 were treated with RT while the remainder made up the non-RT group. Fifty-two RT recipients underwent combination treatments within 4 weeks after the first RT treatment, and were defined as the combination RT group. We performed propensity score matching (PSM) to compare the RT or combination RT groups with the non-RT group. The endpoint was overall survival (OS).
  
  
  RESULTS
  Median follow-up time for surviving patients was 48 months. After PSM, there was no difference in OS between the RT and non-RT groups or between the combination RT and non-RT groups. However, the combination RT group had a longer median survival time (MST) (10.7 vs. 6.9 months, respectively). Next, we conducted PSM between the combination RT and non-RT groups in patients with tumor sizes ≥10 cm; MST was significantly longer in the former group (10.1 vs. 5.4 months, respectively; bootstrap 95% confidence interval of the difference in MST: 0.2-11.8).
  
  
  CONCLUSIONS
  As a combined modality, RT is a plausible therapeutic option for liver-confined but non-resectable BCLC stage C large HCC patients.
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.|Korean Liver Cancer Study Group, Seoul, Korea.
authors.forename: Hong In
authors.initials: HI
authors.lastname: Yoon
authors.affiliation: Department of Biostatistics & Medical Informatics, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Inkyung
authors.initials: I
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.|Korean Liver Cancer Study Group, 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, Yonsei University Health System, 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; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000532:radiotherapy* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000008:administration & dosage; D057216:Propensity Score; D012042:Registries; D012044:Regression Analysis; D056910:Republic of Korea; D012189:Retrospective Studies; D000077157:Sorafenib; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: BCLC stage C; large hepatocellular carcinoma; median survival time; propensity score matching; radiotherapy