Comparison of clinical outcomes between cone beam CT-guided thermal ablation and helical tomotherapy in pulmonary metastases from hepatocellular carcinoma

Feihang Wang; Feihang Wang; Feihang Wang; Shaonan Fan; Qin Shi; Qin Shi; Qin Shi; Danyang Zhao; Danyang Zhao; Danyang Zhao; Huiyi Sun; Yav Sothea; Yav Sothea; Yav Sothea; Mengfei Wu; Huadan Song; Yi Chen; Yi Chen; Yi Chen; Jiemin Cheng; Jiemin Cheng; Jiemin Cheng; Zhaochong Zeng; Zhiping Yan; Zhiping Yan; Zhiping Yan; Jian He; Lingxiao Liu; Lingxiao Liu; Lingxiao Liu

doi:10.3389/fonc.2022.947284

Frontiers in Oncology (Aug 2022)

Comparison of clinical outcomes between cone beam CT-guided thermal ablation and helical tomotherapy in pulmonary metastases from hepatocellular carcinoma

Feihang Wang,
Feihang Wang,
Feihang Wang,
Shaonan Fan,
Qin Shi,
Qin Shi,
Qin Shi,
Danyang Zhao,
Danyang Zhao,
Danyang Zhao,
Huiyi Sun,
Yav Sothea,
Yav Sothea,
Yav Sothea,
Mengfei Wu,
Huadan Song,
Yi Chen,
Yi Chen,
Yi Chen,
Jiemin Cheng,
Jiemin Cheng,
Jiemin Cheng,
Zhaochong Zeng,
Zhiping Yan,
Zhiping Yan,
Zhiping Yan,
Jian He,
Lingxiao Liu,
Lingxiao Liu,
Lingxiao Liu

Affiliations

Feihang Wang: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
Feihang Wang: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Feihang Wang: National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Shaonan Fan: Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
Qin Shi: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
Qin Shi: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Qin Shi: National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Danyang Zhao: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
Danyang Zhao: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Danyang Zhao: National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Huiyi Sun: Shanghai Medical College, Fudan University, Shanghai, China
Yav Sothea: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
Yav Sothea: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Yav Sothea: National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Mengfei Wu: Department of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), Third Hospital of Hebei Medical University, Shijiazhuang, China
Huadan Song: Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Yi Chen: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
Yi Chen: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Yi Chen: National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Jiemin Cheng: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
Jiemin Cheng: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Jiemin Cheng: National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Zhaochong Zeng: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Zhiping Yan: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
Zhiping Yan: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Zhiping Yan: National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Jian He: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Lingxiao Liu: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
Lingxiao Liu: Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
Lingxiao Liu: National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China

DOI: https://doi.org/10.3389/fonc.2022.947284
Journal volume & issue: Vol. 12

Abstract

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ObjectiveThis retrospective study compares the clinical results of cone beam CT (CBCT)-guided thermal ablation with those of helical tomotherapy in hepatocellular carcinoma (HCC) patients with pulmonary metastases.MethodsA total of 110 patients undergoing thermal ablation or helical tomotherapy for pulmonary metastases from April 2014 to December 2020 were included in the study. The endpoints were local tumor progression-free survival (LTPFS), overall survival (OS), and complications. Univariate and multivariate analyses using the Cox proportional hazard model were conducted to identify independent factors (univariate: P < 0.1; multivariate: P < 0.05). The Kaplan–Meier method was used to calculate the LTPFS and OS rates.ResultsThe results of 106 patients were taken into the final analysis. The 1- and 3-year LTPFS rates were 50 and 19% for the thermal ablation group and 65 and 25% for the helical tomotherapy group. The median LTPFS in the thermal ablation group was 12.1 months, while it was 18.8 months in the helical tomotherapy group (P = 0.25). The 1- and 3-year OS rates were 75 and 26% for the thermal ablation group and 77 and 37% for the helical tomotherapy group. The median OS was 18.0 months in the thermal ablation group and 23.4 months in the helical tomotherapy group (P = 0.38). The multivariate analyses found that α-fetoprotein (AFP) at <400 ng/ml (P = 0.003) was significantly associated with better LTPFS. Tumor number <3 and AFP <400 ng/ml were favorable prognostic factors for OS. There were no grades 3–5 adverse events in both groups. Grade 2 was recorded in three patients (4.8%) in the thermal ablation group and two patients (4.7%) in the helical tomotherapy group.ConclusionsFor pulmonary metastases from HCC, CBCT-guided thermal ablation and helical tomotherapy provided comparable clinical effects and safety.

Published in Frontiers in Oncology

ISSN: 2234-943X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.frontiersin.org/journals/oncology/

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