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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 14 - 2024 |
doi: 10.3389/fonc.2024.1427332
This article is part of the Research Topic Hepatocellular Carcinoma: Novel Treatment Strategies - Volume III View all 7 articles
The role of ALBI score in Patients treated with Stereotactic Body Radiotherapy for Locally Advanced Primary Liver Tumors. A Pooled Analysis of 2 Prospective Studies
Provisionally accepted- 1 Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany
- 2 Department of Radiation Oncology, Medical Center - University of Freiburg, Germany;, Freiburg, Germany
- 3 Department for Radiation Therapy and Radiation Oncology, University Hospital Leipzig, Leipzig, Lower Saxony, Germany
- 4 Department of General and Visceral Surgery, University of Freiburg Medical Center, Freiburg, Germany
- 5 Department of Infectious Diseases, Abteilung für Innere Medizin II, Medizinisches Zentrum, Universität Freiburg, Freiburg, Germany
- 6 University Clinic for Radiotherapy-Radiation Oncology, Medical University of Graz, Graz, Styria, Austria
Introduction To evaluate the outcomes after stereotactic radiotherapy (SBRT) for locally advanced primary liver cancer. Material and Methods Patients with locally advanced liver cancer unsuitable for other loco-regional treatments were treated with SBRT with 50-60 Gy in 3-12 fractions in 2 consecutive prospective trials. Results A total of 83 patients were included of whom 14 were excluded leaving 69 evaluable patients with 74 treated lesions. 50 patients had hepatocellular carcinoma (HCC) and 11 patients a cholangiocarcinoma (CCC). About 76% had a Child- Pugh (CP) score A, while 54% had an albumin-bilirubin (ALBI) score of 1. With a median follow-up of 29 months the median overall survival (OS) was 11 months and the progression free survival (PFS) 18 months. The ALBI score was an important predictor of the overall survival (HR 2.094, p=0.001) which remained significant also in the multivariate analysis. Patients with an ALBI grade of > 1 had an OS of 4 months versus 23 months in patients with an ALBI grade of 1 (p=<.001). The local control at 1- and 2- years was 91%, respectively. Thirteen patients developed grade > 3 toxicities, of whom 9 patients experienced liver toxicities. Patients with a higher ALBI score had a high risk for developing hepatic failure (OR 6.136, p=0.006). Discussion SBRT was very effective treatment with low toxicity and should be considered as a local treatment option in patients with HCC and CCC. Patients with a higher ALBI grade are at risk for developing toxicities after SBRT and have a significantly lower survival rate.
Keywords: HCC, ccc, SBRT, Hepatocellular Carcinoma, Cholangiocarcinoma, Radiotherapy
Received: 03 May 2024; Accepted: 10 Sep 2024.
Copyright: © 2024 Gkika, Radicioni, Eichhorst, Kirste, Sprave, Nicolay, Fichtner-Feigl, Thimme, Wiehle, Brunner and Grosu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Eleni Gkika, Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany
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