Abstract 237P
Background
This study compared the efficacy of radiotherapy alone and radiotherapy plus immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) in patients with hepatocellular carcinoma (HCC) involving severe macrovascular invasion.
Methods
Patients with HCC involving macrovascular invasion (main portal vein or inferior vena cava) who received radiotherapy monotherapy (n=38) or radiotherapy plus ICIs and TKIs (n=60) from January 2019 to December 2023 were retrospectively enrolled. The primary outcome was macrovascular invasion retraction rate. The secondary outcomes included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival.
Results
A total of 98 patients were included. The mean age was 50.8±10.4 years. About one third (35.8%) of patients had extrahepatic spread lesions. A total of 72 (73.5%) patients were with main portal vein tumor thrombus, 16 (16.3%) patients with inferior vena cava tumor thrombus, 10 (10.2%) patients accompanied by main portal vein and inferior vena cava tumor thrombus. The macrovascular invasion retraction rate was 50.0% and 65% in radiotherapy monotherapy group and combined treatment group, respectively. The corresponding ORR and DCR were 36.8% and 81.5% in radiotherapy monotherapy group, and 50% and 91.6% in combined treatment group, respectively. The corresponding median PFS were 7.3 months and 8.0 months. The median overall survival was not reached. The corresponding incidence of all grade treatment-related adverse events were 44.8% and 40%, respectively.
Conclusions
Radiotherapy plus ICIs and TKIs showed higher tumor control rate than radiotherapy monotherapy in patients with HCC involving severe macrovascular invasion.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The Ethics Committee of Guangxi Medical University Cancer Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.