Radiotherapy plus anti-PD1 versus radiotherapy for hepatic toxicity in patients with hepatocellular carcinoma

Radiation Oncology

Research

Liu-Ying Yan¹  Bang-De Xiang²  Shi-Xiong Liang³  Rui-Jun Zhang³  Xiao-Ting Wang³  Mei-Ling He³  Hai-Yan Lu³  Hong-Mei Zhou³  Jian-Xu Li³  Ting-Shi Su³  Hong-Ping Yu⁴  Mo-Qin Qiu⁵  Wei-Zhong Tang⁶  Mei-Ying Long⁷ 

[1] Department of General Affairs, Guangxi Medical University Cancer Hospital, 530021, Nanning, China;Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, 530021, Nanning, China;Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, 530021, Nanning, China;Department of Research, Guangxi Medical University Cancer Hospital, 530021, Nanning, China;School of Public Health, Guangxi Medical University, 530021, Nanning, China;Department of Respiratory Oncology, Guangxi Medical University Cancer Hospital, 530021, Nanning, China;Division of Colorectal & Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, 530021, Nanning, China;School of Public Health, Guangxi Medical University, 530021, Nanning, China;

关键词: Anti-PD1;    Hepatocellular carcinoma;    Propensity score matching;    Radiation-induced liver disease;   

DOI  :  10.1186/s13014-023-02309-1

 received in 2022-09-22, accepted in 2023-06-26,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeIn this study, we aimed to compare the radiation-induced hepatic toxicity (RIHT) outcomes of radiotherapy (RT) plus antibodies against programmed cell death protein 1 (anti-PD1) versus RT alone in patients with hepatocellular carcinoma (HCC), evaluate prognostic factors of non-classic radiation-induced liver disease (ncRILD), and establish a nomogram for predicting the probability of ncRILD.Patients and methodsPatients with unresectable HCC treated with RT and anti-PD1 (RT + PD1, n = 30) or RT alone (n = 66) were enrolled retrospectively. Patients (n = 30) in each group were placed in a matched cohort using propensity score matching (PSM). Treatment-related hepatotoxicity was evaluated and analyzed before and after PSM. The prognostic factors affecting ncRILD were identified by univariable logistic analysis and Spearman’s rank test in the matched cohort to generate a nomogram.ResultsThere were no differences in RIHT except for increased aspartate aminotransferase (AST) ≥ grade 1 and increased total bilirubin ≥ grade 1 between the two groups before PSM. After PSM, AST ≥ grade 1 occurred more frequently in the RT + PD1 group (p = 0.020), and there were no significant differences in other hepatotoxicity metrics between the two groups. In the matched cohort, V25, tumor number, age, and prothrombin time (PT) were the optimal prognostic factors for ncRILD modeling. A nomogram revealed a good predictive performance (area under the curve = 0.82).ConclusionsThe incidence of RIHT in patients with HCC treated with RT + PD1 was acceptable and similar to that of RT treatment. The nomogram based on V25, tumor number, age, and PT robustly predicted the probability of ncRILD.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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