PMID- 35998838
OWN - NLM
STAT- MEDLINE
DCOM- 20221020
LR  - 20221101
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 175
DP  - 2022 Oct
TI  - Systematic review of adjuvant external beam radiotherapy for hepatocellular 
      carcinoma following radical hepatectomy.
PG  - 101-111
LID - S0167-8140(22)04240-2 [pii]
LID - 10.1016/j.radonc.2022.08.019 [doi]
AB  - BACKGROUND AND AIM: Recurrence remains the main bottleneck hindering outcomes of 
      hepatectomy for hepatocellular carcinoma (HCC). Owing to technological advances, 
      external beam radiotherapy (EBRT) is being increasingly used in the management of 
      HCC; however, there is no consensus on the role of adjuvant EBRT following 
      hepatectomy. METHODS: A systematic review was conducted according to the 
      guidelines of the Preferred Reporting Items for Systematic Reviews and 
      Meta-Analysis. PubMed, MedLine, Embase, the Cochrane Library, Web of Knowledge 
      were used to screen eligible studies (published as of May 1st, 2022) that 
      evaluated the clinical safety and efficacy of EBRT for HCC receiving hepatectomy. 
      The endpoints were disease-free survival (DFS), overall survival (OS), and 
      adverse events (AEs). RESULTS: A total of ten studies were eligible (three 
      randomized controlled trials, one phase II trial, and six retrospective 
      comparative studies). The pooled hazard ratio (HR) for median DFS and OS were 
      both in favor of adjuvant EBRT compared with surgery alone (all P < 0.05), and 
      the advantage of adjuvant EBRT was also confirmed in subgroups stratified by 
      different populations (narrow margin, P < 0.05; microvascular invasion, P < 0.05; 
      portal vein tumor thrombus, P < 0.05) and study designs (prospective studies, 
      P < 0.05; retrospective studies, P < 0.05). Adjuvant EBRT was also found to be 
      superior to adjuvant TACE (P < 0.05). Pooled rates of overall AEs and severe AEs 
      were 65.3% and 12.2%, but no fatal AEs were reported. CONCLUSION: Adjuvant EBRT 
      can be considered for HCC patients, especially those with a high risk of 
      recurrence. Further studies are required for validation of these findings.
CI  - Copyright (c) 2022 The Authors. Published by Elsevier B.V. All rights reserved.
FAU - Wang, Lei
AU  - Wang L
AD  - Department of Radiation Oncology, Clinical Oncology School of Fujian Medical 
      University, Fujian Cancer Hospital, Fuzhou, China.
FAU - Qiu, Lu
AU  - Qiu L
AD  - Department of Radiation Oncology, Zhangzhou Affiliated Hospital of Fujian Medical 
      University, Zhangzhou, China.
FAU - Ke, Qiao
AU  - Ke Q
AD  - Department of Hepatopancreatobiliary Surgery, Clinical Oncology School of Fujian 
      Medical University, Fujian Cancer Hospital, Fuzhou, China.
FAU - Ji, Hongbing
AU  - Ji H
AD  - Department of Radiation Oncology, Mengchao Hepatobiliary Hospital of Fujian 
      Medical University, Fuzhou, Fujian, China. Electronic address: fjjhb8@sina.com.
FAU - Wu, Junxin
AU  - Wu J
AD  - Department of Radiation Oncology, Clinical Oncology School of Fujian Medical 
      University, Fujian Cancer Hospital, Fuzhou, China. Electronic address: 
      junxinwufj@aliyun.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20220822
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Humans
MH  - *Carcinoma, Hepatocellular/radiotherapy/surgery/pathology
MH  - Hepatectomy/adverse effects
MH  - *Liver Neoplasms/radiotherapy/surgery/pathology
MH  - Retrospective Studies
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Radiotherapy, Adjuvant/adverse effects
MH  - *Chemoembolization, Therapeutic
MH  - Randomized Controlled Trials as Topic
MH  - Clinical Trials, Phase II as Topic
OTO - NOTNLM
OT  - Disease-free survival
OT  - External beam radiotherapy
OT  - Hepatectomy
OT  - Hepatocellular carcinoma
OT  - Systematic review
EDAT- 2022/08/24 06:00
MHDA- 2022/10/21 06:00
CRDT- 2022/08/23 19:26
PHST- 2022/05/18 00:00 [received]
PHST- 2022/08/11 00:00 [revised]
PHST- 2022/08/16 00:00 [accepted]
PHST- 2022/08/24 06:00 [pubmed]
PHST- 2022/10/21 06:00 [medline]
PHST- 2022/08/23 19:26 [entrez]
AID - S0167-8140(22)04240-2 [pii]
AID - 10.1016/j.radonc.2022.08.019 [doi]
PST - ppublish
SO  - Radiother Oncol. 2022 Oct;175:101-111. doi: 10.1016/j.radonc.2022.08.019. Epub 
      2022 Aug 22.