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ASCOBT 2023: Can Serum-Based Parameters Predict Outcomes in Unresectable Liver Cancer?

By: Julia Fiederlein Cipriano, MS
Posted: Monday, August 14, 2023

A retrospective analysis, which was presented during the 2023 American Society of Clinical Oncology (ASCO) Breakthrough meeting (Abstract 48) in Yokohama, Japan, demonstrated the predictive utility of distinct serum-based parameters for the rates of overall survival, local tumor control, and distant tumor control in patients with unresectable hepatocellular carcinoma who were undergoing curative radiation therapy. However, Dong-Soo Lee, MD, PhD, of the Catholic University of Korea, Seoul, explained that further research is needed to confirm these findings.

A total of 71 patients (mean age, 61.4 years) who collectively underwent 76 courses of radiation therapy were included in the study. The median radiation therapy fraction number, fractional doses, and biologically equivalent doses (calculated with an alpha/beta ratio of 10 Gy) were 12.0, 5.0 Gy, and 72.6 Gy, respectively. Before such treatment, the majority of patients (97.4%) received transarterial chemoembolization plus hepatic arterial infusion chemotherapy.

The following parameters were considered in the analysis: systemic inflammation index; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; prognostic nutritional index; absolute lymphocyte count; lymphocyte-to-monocyte ratio; albumin; albumin-to–alkaline phosphatase ratio; radiation therapy–related parameters; and levels of total protein, hemoglobin, alpha-fetoprotein, PIVKA-II, and C-reactive protein. Follow-up data were provided for a median of 12 months.

The 1-year rates of overall survival, local tumor control, distant tumor control, and intrahepatic tumor control were 55.2%, 88.2%, 64.4%, and 50.5%, respectively. Based on a multivariate analysis, significant independent prognostic indicators were the lowest posttreatment prognostic nutritional index for overall survival (P < .001), lowest pretreatment lymphocyte-to-monocyte ratio for local tumor control (P = .03), and highest posttreatment platelet-to-lymphocyte ratio for distant tumor control (P = .006).

Disclosure: The study author reported no conflicts of interest.

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