Stereotactic ablative radiotherapy for hepatocellular carcinoma: A systematic review and meta‐analysis of local control, survival and toxicity outcomes

医学 SABR波动模型 肝细胞癌 置信区间 荟萃分析 毒性 内科学 放射治疗 人口 剂量分馏 肿瘤科 外科 金融经济学 环境卫生 经济 波动性(金融) 随机波动
作者
Mihir Shanker,Pereshin Moodaley,W.L. Soon,Howard Liu,Yoo-Young Lee,David Pryor
出处
期刊:Journal of Medical Imaging and Radiation Oncology 卷期号:65 (7): 956-968 被引量:17
标识
DOI:10.1111/1754-9485.13309
摘要

Summary There is a growing body of literature supporting the use of stereotactic ablative body radiotherapy (SABR) in the management of primary hepatocellular carcinoma (HCC). This systematic review and meta‐analysis of the current published evidence for SABR for HCC assessed the impact of treatment dose, fractionation and tumour size on the outcomes of local control (LC), overall survival (OS) and toxicity. A systematic search was independently performed by two authors for articles published in peer‐reviewed journals between January 2005 and December 2019. A DerSimonian and Laird random effects model was used to assess pooled results. A multivariate meta‐regression analysis incorporated the effect of explanatory variables (radiation dose in EQD2 [10], fractionation and tumour size) on outcomes of OS, LC and toxicity. Forty‐nine cohorts involving 2846 HCC patients with 3088 lesions treated with SABR were included. Pooled 1‐, 2‐ and 3‐year LC rates were 91.1% (95% confidence interval [CI] 88.3–93.2), 86.7% (95% CI 82.7–89.8) and 84.2% (95% CI 77.9–88.9) respectively. Pooled 1‐, 2‐ and 3‐year OS rates were 78.4% (95% CI 73.4–82.6), 61.3% (55.2–66.9) and 48.3% (95% CI 39.0–57). Population‐weighted median grade 3 toxicity rates were 6.5% (IQR 3.2–16) and mean grade 4/5 rates were 1.4% (IQR 0–2.1). Within EQD2 [10] ranges of 40 to 83.33 Gy corresponding to common dose‐fractionation regimens of 30–50 Gy in 5 fractions, there was a multivariate association between superior LC and OS with increasing EQD2 [10] , with a proportionately smaller increase in grade 3 toxicity and no association with grade 4/5 toxicity. Stereotactic ablative body radiotherapy is a viable treatment option for HCC with high LC rates and low rates of reported grade 3/4 toxicity. Increasing EQD2 [10] was associated with improvements in LC and OS with a comparatively smaller increase in toxicity. Prospective randomised trials are warranted to define optimal patient selection and dose‐fractionation regimens.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
科研通AI5应助优秀的绿蕊采纳,获得10
刚刚
健忘的初翠完成签到,获得积分10
刚刚
2秒前
lwm不想看文献完成签到 ,获得积分10
2秒前
4秒前
拼搏一曲发布了新的文献求助10
5秒前
CAOHOU应助科研通管家采纳,获得10
6秒前
共享精神应助科研通管家采纳,获得10
6秒前
CAOHOU应助科研通管家采纳,获得10
6秒前
SYLH应助科研通管家采纳,获得20
6秒前
乐乐应助科研通管家采纳,获得10
6秒前
汉堡包应助科研通管家采纳,获得10
6秒前
FashionBoy应助科研通管家采纳,获得10
6秒前
桐桐应助科研通管家采纳,获得10
6秒前
6秒前
深情安青应助科研通管家采纳,获得10
6秒前
CAOHOU应助科研通管家采纳,获得10
6秒前
SYLH应助科研通管家采纳,获得10
6秒前
CAOHOU应助科研通管家采纳,获得10
6秒前
Owen应助科研通管家采纳,获得10
7秒前
SYLH应助科研通管家采纳,获得10
7秒前
SYLH应助科研通管家采纳,获得10
7秒前
7秒前
酷波er应助科研通管家采纳,获得10
7秒前
wushuwen发布了新的文献求助10
7秒前
8秒前
xuan完成签到,获得积分10
9秒前
完美世界应助段一帆采纳,获得10
11秒前
少敏敏完成签到,获得积分10
13秒前
may发布了新的文献求助10
13秒前
18秒前
20秒前
兜兜关注了科研通微信公众号
20秒前
wbh完成签到,获得积分10
21秒前
太牛的GGB发布了新的文献求助10
21秒前
wbh发布了新的文献求助10
23秒前
乐乐应助may采纳,获得10
23秒前
顺利的梦菲完成签到 ,获得积分10
24秒前
777完成签到 ,获得积分10
24秒前
上官若男应助忧郁盼夏采纳,获得10
25秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989378
求助须知:如何正确求助?哪些是违规求助? 3531442
关于积分的说明 11254002
捐赠科研通 3270126
什么是DOI,文献DOI怎么找? 1804887
邀请新用户注册赠送积分活动 882087
科研通“疑难数据库(出版商)”最低求助积分说明 809173