Evidence map›Paper›PMID 36271176›Full record

Trial reportHepatology international2022

Radiotherapy prior to or after transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with portal vein tumor thrombus: a randomized controlled trial.

Lei Guo, Xubiao Wei, Shuang Feng, Jian Zhai, Weixing Guo, Jie Shi, Wan Yee Lau, Yan Meng, Shuqun Cheng

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Hepatology international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Lei Guo *Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, 225 Changhai Road, Yangpu District, Shanghai, 200438, China.
Xubiao Wei *Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, 225 Changhai Road, Yangpu District, Shanghai, 200438, China.
Shuang Feng *Department of Radiotherapy, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, 225 Changhai Road, Yangpu District, Shanghai, 200438, China.
Jian ZhaiDepartment of Intervention, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, 200438, China.
Weixing GuoDepartment of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, 225 Changhai Road, Yangpu District, Shanghai, 200438, China.
Jie ShiDepartment of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, 225 Changhai Road, Yangpu District, Shanghai, 200438, China.
Wan Yee LauDepartment of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, 225 Changhai Road, Yangpu District, Shanghai, 200438, China.
Yan MengDepartment of Radiotherapy, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, 225 Changhai Road, Yangpu District, Shanghai, 200438, China. yanmeng_ehbh@163.com.
Shuqun ChengDepartment of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, 225 Changhai Road, Yangpu District, Shanghai, 200438, China. chengshuqun@aliyun.com.ORCID http://orcid.org/0000-0001-6760-7470
Second Military Medical University · CNChinese University of Hong Kong · HK

Funding

the Clinical Research Plan of Shanghai Shenkang Hospital Development Center SHDC2020CR1004Athe Natural Science Foundation of China 82072618the Natural Science Foundation of China 82102941the Project of Shanghai Municipal Science and Technology Commission 20Y11908800the San Hang Program of Navy Medical University 2021the State Key Program of National Natural Science Foundation of China 81730097
6 · The paper itself

Abstract

introductionTo compare survival outcomes of radiotherapy (RT) prior to transcatheter arterial chemoembolization (TACE) (RT + TACE) with TACE followed with RT (TACE + RT) in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT).

methodsA randomized controlled study was conducted from August 2016 to December 2019 on patients with unresectable HCC and PVTT. The patients were randomly assigned to RT + TACE group or TACE + RT group in a 1:1 ratio. Evaluation of therapeutic effects on the primary tumor was based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST), while that on PVTT was based on the changing of Cheng's PVTT classification. The primary end-point was overall survival (OS).

resultsThe 120 patients who entered this study were evenly assigned to two groups. In the intention-to-treat (ITT) population, the OS rates for RT + TACE group at 1, 2 and 3 years were 61.7%, 27.4% and 15.6%, compared with 45.0%, 16.1% and 4.7% in TACE + RT group. The median OS was increased in patients with RT + TACE compared with those who had TACE + RT with a marginally significance (15.4 versus 11.5 months, HR = 0.68, 95% CI 0.46-1.01, p = 0.054). The median progression-free survival (PFS) in RT + TACE group was 6.6 months versus 4.2 months in TACE + RT group (HR = 0.66, 95% CI 0.46-0.96, p = 0.030). The corresponding disease control rate (DCR) at 3 months was 86.7% versus 66.7% (p = 0.017) and 61.7% versus 46.7% (p = 0.099) at 6 months. In subgroup analyses, RT + TACE was associated with better OS (HR, 0.48; 95% CI 0.33-0.99, p = 0.048) and PFS (HR, 0.55; 95% CI 0.33-0.93, p = 0.026) versus TACE + RT among patients with type III/IV PVTT. There were 3 patients in RT + TACE group and 2 in TACE + RT group had adverse events ≥  grade 3.

conclusionApplying RT prior to TACE provided better survival outcomes than TACE followed by RT for patients with HCC and PVTT, which may act as an optimized regional modality to further improve local control rates (Trial registration: ChiCTR ChiCTR2000033573.).

Indexed as

Carcinoma, HepatocellularChemoembolization, TherapeuticLiver NeoplasmsThrombosisHumansPortal VeinRetrospective StudiesTreatment OutcomeHepatocellular carcinomaPortal vein tumor thrombusRadiotherapySequential treatmentTranscatheter arterial chemoembolization

Identifiers

PMID36271176
OpenAlexW4307026307

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.