ArticleClinical and translational radiation oncology2027
CyberKnife SBRT plus lenvatinib and tislelizumab versus doublet systemic therapy for hepatocellular carcinoma with macrovascular invasion: A real-world IPTW-adjusted study.
Article in Clinical and translational radiation oncology, 2027. 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 & purpose: Macrovascular invasion (MVI) in hepatocellular carcinoma (HCC) confers extremely poor prognosis. While lenvatinib plus tislelizumab is an active targeted-immunotherapy regimen, local control of tumor thrombus remains suboptimal. Stereotactic body radiotherapy (SBRT) delivered via CyberKnife offers highly conformal local treatment and may have immunomodulatory effects. We evaluated whether adding CyberKnife SBRT to doublet systemic therapy was associated with improved outcomes in HCC with MVI. Materials & methods: This real-world retrospective study included 116 HCC patients with MVI (Triple group: CyberKnife SBRT + lenvatinib + tislelizumab, Results: The observed confirmed ORR was 68.0% (34/50) in the Triple Group versus 37.9% (25/66) in the Doublet Group; the stabilized IPTW-weighted ORR was 71.1% versus 37.6% ( Conclusion: In this selected cohort of patients with advanced HCC, MVI, preserved performance status, and Child-Pugh A/B7 liver function, the addition of CyberKnife SBRT to lenvatinib and tislelizumab was associated with higher confirmed response rates, longer local control, and prolonged PFS and OS, without a clear excess of severe toxicity. These findings support prospective evaluation of CyberKnife SBRT as a local-treatment component of first-line combined-modality therapy in carefully selected patients with HCC and MVI.
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