Overall Survival Among Patients With Hepatocellular Carcinoma Treated With External Beam Radiation Therapy: Individual Patient Data Outcomes From a Multinational Cohort.

We analyzed individual patient data (IPD) from an international cohort to assess OS among patients with HCC treated with EBRT.

我们分析了来自国际队列的个体患者数据（IPD），以评估接受EBRT治疗的HCC患者的总生存（OS）。

Methods

We performed a systematic reviewof publications that assessed EBRT, met prespecified technical standards for HCC, and reported OS (search date December 15, 2022).

我们对评估了外照射放疗（EBRT）、符合肝细胞癌（HCC）预设技术标准并报告了总生存期（OS）的出版物进行了系统回顾（搜索日期为2022年12月15日）。

Corresponding authors were invited to submit IPD for the study.

我们邀请了相关作者提交本研究的个体患者数据（IPD）。

We performed Kaplan-Meier survival analyses to determine OS and restricted mean survival time (RMST) stratified by Barcelona Clinic Liver Cancer (BCLC) stage and treatment status (ie, treatment-naïve and experienced).

我们进行了Kaplan-Meier生存分析，以确定按巴塞罗那肝癌临床分期（BCLC）和治疗状态（即治疗前和治疗后）分层的总生存期（OS）和限制性平均生存时间（RMST）。

We performed random effects Cox proportional hazards modeling to assess clinical characteristics associated with OS.

我们进行了随机效应Cox比例风险模型分析，以评估与总生存期（OS）相关的临床特征。

Results

Data were provided on 4,913 patients treated with EBRT with a median follow-up time of 5.0 years.

提供了4913名接受EBRT治疗的患者的资料，中位随访时间为5.0年。

The median OS was 6.8 years (95% CI, 5.7 to 8.7) for BCLC-0 and 4.6 years (95% CI, 4.1 to 5.1) for BCLC-A.

BCLC-0患者的中位总生存期为6.8年（95%置信区间，5.7至8.7年），而BCLC-A患者的中位总生存期为4.6年（95%置信区间，4.1至5.1年）。

Among treatment-naïve patients, the median OS was not reached (95% CI, 8.6 to not reached) for BCLC-0 and was 5.4 years (95% CI, 4.5 to 6.7) for BCLC-A.

在未接受治疗的患者中，BCLC-0的中位总生存期未达到（95%置信区间，8.6至未达到），而BCLC-A的中位总生存期为5.4年（95%置信区间，4.5至6.7年）。

In multivariable models, more advanced BCLC stage, higher tumor burden, worse performance status, and Child-Pugh class B or C were associated with a higher risk of mortality.

在多变量模型中，更晚期的BCLC分期、更高的肿瘤负担、更差的体能状态以及Child-Pugh B级或C级与更高的死亡风险相关。

Ablative radiation dose and more recent year of treatment were associated with a reduced risk of death.

消融放射剂量和更近期的治疗年份与死亡风险降低相关。

Conclusions

To our knowledge, this study represents the largest multinational cohort of patients with HCC treated with EBRT.

据我们所知，本研究代表了接受外照射治疗的肝细胞癌患者中最大的多国别队列。

OS outcomes with EBRT for very early- and early-stage HCC appear to be comparable with resection, thermal ablation, and other ablative locoregional therapies.

对于非常早期和早期肝细胞癌(HCC)，外照射治疗(EBRT)的总生存(OS)结果似乎与其他治疗方法如手术、热消融和其他局部消融治疗相当。

These data support the inclusion of EBRT in the BCLC HCC clinical decision-making process.

这些数据支持在巴塞罗那临床肝癌(BCLC)分期系统中将EBRT纳入HCC的临床决策过程。