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Efficacy and safety of subsequent radiotherapy in patients with advanced-stage hepatocellular carcinoma treated with immune checkpoint inhibitors

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 882-897,I0010页

作者： Cong Ning Jun Jia Xinmu Zhang Jing Sun Yunchao Wang Jingnan Xue Longhao Zhang Xiaorong Hou Xiaobo Yang Xinting Sang Xuezhang Duan Haitao Zhao Department of Liver Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical College(CAMS&PUMC)BeijingChina Department of radiotherapy Senior Department of OncologyThe Fifth Medical Center of People’s Liberation Army(PLA)General HospitalChinese PLA Medical SchoolBeijingChina Department of Radiation Oncology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical College(CAMS&PUMC)BeijingChina

Background:The development of immunotherapy resistance is associated with a poor prognosis in patients diagnosed with hepatocellular carcinoma(HCC)who are undergoing treatment with immune checkpoint inhibitors(ICI).This study aimed to evaluate the efficacy and safety of subsequent radiotherapy(RT)for patients with advanced-stage HCC who had lesion enlargement or new lesions(NLs)during ICI ***:This retrospective observational study enrolled 36 patients with advanced-stage HCC who underwent subsequent RT for lesion enlargement or NLs during ICI therapy from two *** primary endpoints were progression-free survival(PFS)and overall survival(OS).The secondary endpoints included objective response rate(ORR),disease control rate(DCR),1-and 2-year local control(LC)rates,in-field PFS(IFPFS),out-field PFS(OFPFS),and ***:The median follow-up time was 15.3 *** median PFS was 7.4 months[95%confidence interval(CI):3.1-11.7 months],and the median OS was 18.8 months(95%CI:17.1-20.5 months).ORR and DCR were 38.9%and 72.2%,*** addition,the median IFPFS was 17.8 months(95%CI:11.5-24.2 months),median OFPFS was 7.9 months(95%CI:3.4-12.5 months),and estimated 1-and 2-year LC rates were 67.1%and 31.9%,*** most common treatment-related adverse events(all grades)were diarrhea(33.3%),rash(30.6%),and malaise(27.8%);a total of 14(38.9%)patients developed grade 3-4 ***:subsequent RT showed reliable antitumor effects and an acceptable safety profile in patients with advanced-stage HCC who had unsatisfactory response to ICI therapy;therefore,it could serve as an optional salvage strategy.

关键词： subsequent radiotherapy immunotherapy immune checkpoint inhibitors(ICIs) disease status advanced-stage hepatocellular carcinoma

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