ArticleTranslational cancer research2025
A nomogram for predicting overall survival in advanced hepatocellular carcinoma patients receiving radiotherapy combined with targeted therapy: a multicenter retrospective study.
Article in Translational cancer research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Although radiotherapy (RT) combined with targeted therapy has emerged as a viable treatment for advanced hepatocellular carcinoma (HCC), predicting survival outcomes remains difficult. This study aimed to develop and validate a prognostic model integrating clinical parameters to predict overall survival (OS) in patients with advanced-stage HCC receiving RT combined with targeted therapy. Methods: A total of 248 advanced HCC patients treated with intensity-modulated RT (IMRT) combined with targeted therapy were retrospectively enrolled from three tertiary hospitals in China and randomly divided into training (n=148) and validation (n=100) cohorts. Least absolute shrinkage and selection operator (LASSO) regression followed by multivariable Cox analysis was used to identify independent prognostic factors. A nomogram was constructed to predict 1-, 2-, and 3-year OS, and its performance was evaluated using time-dependent receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Results: In the training cohort, a prognostic nomogram was developed based on four independent prognostic factors: Child-Pugh classification, portal vein tumor thrombosis (PVTT), M stage, and alpha-fetoprotein (AFP) level. In the validation cohort, this nomogram achieved promising predictive performance, with AUC values of 0.688, 0.817, and 0.847 for 1-, 2-, and 3-year OS, respectively. Calibration curves indicated excellent consistency between predicted and actual survival outcomes. Moreover, DCA demonstrated favorable net clinical benefit across all time points. Conclusions: The proposed LASSO-Cox-based nomogram enables individualized survival prediction in patients with advanced HCC treated with RT combined with targeted therapy.
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