The role of external beam radiotherapy for hepatocellular carcinoma patients with lymph node metastasis: A meta-analysis of observational studies

Chai Hong Rim, Chul Yong Kim, Dae Sik Yang, Won Sup Yoon

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)

    Abstract

    Purpose: Lymph node metastasis of hepatocellular carcinoma is categorized as advanced in Barcelona Clinic of Liver Cancer staging, and sorafenib is a sole treatment recommended. However, appliance of local treatment including external beam radiotherapy (EBRT) has not been uncommon. We performed a meta-analysis and systemically reviewed current literature to evaluate the efficacy and safety of EBRT. Methods: PubMed, Medline, Cochrane library, and Embase were systemically searched until December 17, 2017. The primary endpoint of analyses was response rate (RR), and 1-year overall survival and complication rates of grade ≥3 were secondary endpoints. Complications were primarily assessed descriptively. Results: A total of 8 studies comprising 521 patients were included. The pooled RR was 73.1% (95% confidence interval [CI]: 63.6–80.9), and high-dose EBRT groups had better RR than the low-dose group (82.2% [95% CI: 74.4–88.1] vs 51.1% [95% CI: 40.3–61.7]; P=0.001]. The pooled 1-year overall survival rate was 41.0% (95% CI: 32.9–49.6). Six studies assessed the survival benefit according to RR, and 5 (83.3%) of these 6 studies reported statistically significant survival benefit. The most common grade ≥3 toxicities were thrombocytopenia and gastrointestinal complication, with pooled rates of 3.4% (95% CI: 1.2–9.5) and 3.5% (95% CI:1.7–7.2), respectively. Conclusion: EBRT showed a pooled RR of 73.1% and was safely performed. EBRT might palliate symptoms through tumor reductions and improve survival. Use of sorafenib combined or sequentially with EBRT can be recommended rather than monotherapy.

    Original languageEnglish
    Pages (from-to)3305-3315
    Number of pages11
    JournalCancer Management and Research
    Volume10
    DOIs
    Publication statusPublished - 2018

    Keywords

    • Hepatocellular carcinoma
    • Lymph node metastasis
    • Meta-analysis
    • Radiation therapy

    ASJC Scopus subject areas

    • Oncology

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