Comparing the prognostic value of quantitative response assessment tools and LIRADS treatment response algorithm in patients with hepatocellular carcinoma following interstitial high-dose-rate brachytherapy and conventional transarterial chemoembolization

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Item Type:	Article
Title:	Comparing the prognostic value of quantitative response assessment tools and LIRADS treatment response algorithm in patients with hepatocellular carcinoma following interstitial high-dose-rate brachytherapy and conventional transarterial chemoembolization
Creators Name:	Schmidt, R., Rueger, C., Xu, H., He, Y., Yilmaz, E.Y., Heidemann, L., Sulejmani, O., Liu, Y., Noack, L., Hesse, F., Ruppel, R., Abosabie, S.A., Hamm, C.A., Penzkofer, T., Gebauer, B. and Savic, L.J.
Abstract:	BACKGROUND/OBJECTIVES: The aim of this study was to investigate the prognostic value of established response assessment tools for hepatocellular carcinoma (HCC) treated with high-dose-rate interstitial brachytherapy (iBT) alone or with transarterial chemoembolization (cTACE). METHODS: (Non-)responders were categorized using size-based RECIST 1.1 and WHO criteria, enhancement-based mRECIST and EASL criteria, and the LI-RADS Treatment Response Algorithm (LR-TRA). The outcomes were the overall survival (OS), progression-free survival (PFS), and time to progression (TTP). The statistics used included Fisher’s exact test, a t-test, the Mann–Whitney-U test, and a Kaplan–Meier analysis. The median OS, PFS, and TTP were higher in patients following iBT (26.3, 9.1, and 13.0 months) than following cTACE/iBT (23.3, 7.6, and 9.2 months). RESULTS: The enhancement-based criteria identified more responders and predicted PFS and TTP better compared to the size-based criteria. At two months, the cTACE/iBT responders showed improved PFS (mRECIST and EASL: 11.3 vs. 2.3 and 11.0 vs. 2.3, p < 0.01) and TTP (mRECIST and EASL: 11.9 vs. 2.4 months, p < 0.01) by the enhancement-based criteria. An EASL assessment at five months predicted improved survival following both cTACE/iBT (PFS: 11.9 vs. 5.1 months, p = 0.03; TTP: 12.4 vs. 5.0, p < 0.01) and iBT (11.1 vs. 5.1 months, p = 0.04; 13.0 vs. 5.3, p < 0.01). The LR-TRA showed OS benefits at five months for cTACE/iBT responders. Size-based criteria were not prognostic. CONCLUSIONS: Extending follow-up post-iBT or post-iBT/cTACE may improve responder stratification and prognostication.
Keywords:	Hepatocellular Carcinoma, Locoregional Therapies, Interstitial Brachytherapy, Transarterial Chemoembolization, Response Assessment, LIRADS Treatment Response Algorithm
Source:	Cancers
ISSN:	2072-6694
Publisher:	MDPI
Volume:	17
Number:	8
Page Range:	1275
Date:	9 April 2025
Official Publication:	https://doi.org/10.3390/cancers17081275
PubMed:	View item in PubMed

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