The role of albumin-bilirubin grade and inflammation-based index in patients with hepatocellular carcinoma treated with stereotactic body radiotherapy.
Title | The role of albumin-bilirubin grade and inflammation-based index in patients with hepatocellular carcinoma treated with stereotactic body radiotherapy. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Gkika, E., Bettinger D., Krafft L., Schultheiss M., Neeff H. Philipp, Maruschke L., Schulenburg M., Adebahr S., Kirste S., Nestle U., Thimme R., Grosu A-L., & Brunner T. Baptist |
Journal | Strahlenther Onkol |
Volume | 194 |
Issue | 5 |
Pagination | 403-413 |
Date Published | 2018 05 |
ISSN | 1439-099X |
Keywords | Adult, Aged, Aged, 80 and over, alpha-Fetoproteins, Bilirubin, C-Reactive Protein, Carcinoma, Hepatocellular, Female, Follow-Up Studies, Humans, Inflammation Mediators, Liver Neoplasms, Male, Middle Aged, Neoplasm Staging, Prognosis, Radiosurgery, Serum Albumin, Statistics as Topic, Survival Analysis |
Abstract | PURPOSE: We evaluated the prognostic accuracy of the albumin-bilirubin (ALBI) grade and the inflammation-based index (IBI) in estimating overall survival (OS) and toxicity in patients with hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT).MATERIALS AND METHODS: Forty patients with 47 HCC lesions with a Barcelona Clinic Liver Cancer (BCLC) classification stage B or C were treated with SBRT in 3-12 fractions. The ALBI grade and the IBI were calculated at different time points (baseline, during, at the end of treatment and at follow-up) and compared with the Child-Pugh (CP) score as well as other patient- and treatment-related parameters, concerning OS and toxicity.RESULTS: The median follow-up was 14.3 months for patients alive. The median OS from SBRT was 10 (95% confidence interval 8.3-11.6) months. The local control at 1 year was 79%. A lower IBI during treatment was associated with better OS (p = 0.034) but not CP and ALBI. Higher C‑reactive protein levels as well as higher alpha-fetoprotein concentrations correlated with worse survival (p = 0.001). Both higher ALBI (p = 0.02) and CTP (p = 0.001) at baseline correlated with a higher incidence of acute and late toxicities (CTC ≥2). Neither the mean radiation dose to the liver nor the dose to 700 cc of the liver correlated with the occurrence of toxicities.CONCLUSIONS: In this analysis, a higher ALBI grade as well as a higher CP were predictors of higher incidence of toxicity, whereas a lower IBI during treatment correlated with a better OS. These results should be further evaluated in prospective studies. |
DOI | 10.1007/s00066-017-1256-0 |
Alternate Journal | Strahlenther Onkol |
PubMed ID | 29322205 |