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ASTRO 2022: Phase II Trial Compares TACE and SBRT in Hepatocellular Carcinoma

By: Vanessa A. Carter, BS
Posted: Friday, November 4, 2022

Alejandra Mendez Romero, MD, PhD, of Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands, and colleagues compared the use of transarterial chemoembolization (TACE) delivered via drug-eluting beads with stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma. Presented during the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 294), the results of this trial suggested that SBRT appeared to be more effective than TACE.

“Stereotactic body radiation therapy showed higher local antitumoral activity than transarterial chemoembolization delivered via drug-eluting beads in this small group of hepatocellular carcinoma patients, and no detrimental effects on time to [disease] progression, overall survival, toxicity, and quality of life,” stated the investigators. “But, to overcome poor accrual in randomized trials including stereotactic body radiation therapy, to validate our results, and to generate the evidence needed to include [this therapy] in hepatocellular carcinoma treatment guidelines, international cooperation is needed.”

A total of 30 patients with hepatocellular carcinoma who were eligible for TACE received a maximum of four procedures delivered via drug-eluting beads. SBRT was delivered in six fractions of 8 to 9 Gy.

The median follow-up was 28.1 months. Since two patients were considered ineligible, 16 remained in the TACE arm and 12 in the SBRT arm. One participant on SBRT underwent TACE. The median time to disease progression was 12 and 19 months for TACE and SBRT, respectively.

The median overall survival among patients receiving TACE was 36.8 months, and it was 44.1 months with SBRT. Of note, the 1- and 2-year local control rates for SBRT were 100%, compared with 54.4% and 43.6% with TACE (P = .02). With a stable quality of life maintained in both treatment arms, both therapies resulted in a response rate of over 80%.

Disclosure: Dr. Mendez Romero reported no conflicts of interest.


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