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ANKI- GI > HCC > Flashcards

HCC Flashcards

1
Q

What was the clinical relevance of the Korean study (Yoon et al. JAMA Onc 2018) analyzing EBRT + TACE for HCC?

A

This study showed that for HCC with vascular invasion, TACE+RT led to improved RR, TTP, and OS compared to Sorafenib.

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2
Q

What population was included in the Korean study (Yoon et al. JAMA Onc 2018) analyzing EBRT + TACE for HCC?

A

90 pts with HCC with macroscopic vascular invasion

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3
Q

What regimen was included in the Korean study (Yoon et al. JAMA Onc 2018) analyzing EBRT + TACE for HCC?

A

“<span>→TACE + RT<span> <br></br>vs. <br></br>→sorafenib<br></br><br></br>TACE done q6 weeks with 45 Gy EBRT 3 weeks after first TACE</span></span>”

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4
Q

What were the results of the Korean study (Yoon et al. JAMA Onc 2018) analyzing EBRT + TACE for HCC?

A

<div>Improved outcomes with EBRT+TACE over Sorafenib</div>

<div><br></br></div>

24-week response rate 33% vs. 2%<div>Median TTP 31 weeks vs. 12 weeks<br></br>Median OS 55 weeks vs. 43 weeks</div>

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5
Q

What was the clinical relevance of the Chinese study (Sun et al. Radiother Onc 2019) analyzing post-op IMRT for HCC with tumor thrombus?

A

Showed that post-op IMRT after resection of HCC with thrombus improves OS.

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6
Q

What population was included in the Chinese study (Sun et al. Radiother Onc 2019) analyzing post-op IMRT for HCC with tumor thrombus?

A

52 pts with resected HCC with tumor vein thrombus

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7
Q

What regimen was included in the Chinese study (Sun et al. Radiother Onc 2019) analyzing post-op IMRT for HCC with tumor thrombus?

A

“<span>partial hepatectomy ± thrombectomy →<br></br><br></br>→post-op IMRT<br></br>vs. <br></br>→obs</span>”

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8
Q

What were the results of the Chinese study (Sun et al. Radiother Onc 2019) analyzing post-op IMRT for HCC with tumor thrombus?

A

<div>Improved OS with use of post-op IMRT:</div>

<div><br></br></div>

1, 2, 3-yr OS <br></br>77%/19%/12% vs. 27%/12%/0%<br></br><br></br>Median OS 18.9 vs. 10.8 mos<br></br><br></br>

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9
Q

What was the clinical relevance of the Chinese study (Wei et al. JCO 2019) analyzing pre-op EBRT for HCC with tumor thrombus?

A

Showed that pre-op RT in HCC with tumor vein thrombosis improved OS and disease control.

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10
Q

What population was included in the Chinese study (Wei et al. JCO 2019) analyzing pre-op EBRT for HCC with tumor thrombus?

A

164 pts with resectable HCC with tumor vein thrombus

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11
Q

What regimen was included in the Chinese study (Wei et al. JCO 2019) analyzing pre-op EBRT for HCC with tumor thrombus?

A

“<span>→pre-op RT 18 Gy/6 fx, 3DCRT<span><br></br>vs.<br></br>→no RT<br></br><br></br>surgery 1 month after RT</span></span>”

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12
Q

What were the results of the Chinese study (Wei et al. JCO 2019) analyzing pre-op EBRT for HCC with tumor thrombus?

A

<div>OS improved with preop EBRT:</div>

<div><br></br></div>

1-yr OS 75% vs. 43%<br></br>2-yr OS 27% vs. 9%<br></br><div>2-yr DFS 13% vs. 3%</div><div><br></br>RT caused grade 3 toxicity in 2 patients that led to inoperability</div>

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13
Q

What was the clinical relevance of the Italian study analyzing SBRT vs TACE for HCC after TACE failure?

A

Showed that SBRT improved LC compared to TAE/TACE after incomplete response to TACE.

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14
Q

What population was included in the Italian study analyzing SBRT vs TACE for HCC after TACE failure?

A

40 pts with unresectable HCC s/p TAE/TACE and incomplete response

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15
Q

What regimen was included in the Italian study analyzing SBRT vs TACE for HCC after TACE failure?

A

“after incomplete response to TAE/TACE:<br></br><br></br><span>SBRT </span>vs. TAE/TACE”

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16
Q

What were the results of the Italian study analyzing SBRT vs TACE for HCC after TACE failure?

A

<div>Improved LC with SBRT over TACE:</div>

<div><br></br></div>

Time to LF not reached vs. 8 mos<br></br>2-yr LC 57% vs. 36%

17
Q

What was the clinical relevance of the Chinese study analyzing surgery vs SBRT for resectable HCC (Su et al. IJROBP 2017)?

A

Showed SABR and surgery have similar OS and PFS in this retrospective analysis. SABR is less invasive.

18
Q

What population was included in the Chinese study analyzing surgery vs SBRT for resectable HCC (Su et al. IJROBP 2017)?

A

117 pts with HCC size ≤5 cm, Childs Pugh A, 1-2 nodules

19
Q

What regimen was included in the Chinese study analyzing surgery vs SBRT for resectable HCC (Su et al. IJROBP 2017)?

A

Propensity matched scoring. Retrospective comparison of resection and SABR

20
Q

What were the results of the Chinese study analyzing surgery vs SBRT for resectable HCC (Su et al. IJROBP 2017)?

A

No difference in PFS or OS<br></br><br></br><div>With propensity score matching:<br></br>1, 3, and 5-yr OS<br></br>SABR 100%, 92%, 74%<br></br>Resection 97%, 89%, 69% (p=.405)<br></br><br></br>1, 3, and 5-yr PFS:<br></br>SABR 84%, 59%, 44%<br></br>Resection 69%, 62%, 36% (p=.945)</div>

21
Q

What was the clinical relevance of the Michigan study comparing SBRT and RFA for inoperable HCC (Wahl et al. JCO 2015)?

A

Showed that SBRT for tumors of size >2 cm showed improved LC over RFA.

22
Q

What population was included in the Michigan study comparing SBRT and RFA for inoperable HCC (Wahl et al. JCO 2015)?

A

224 pts with inoperable, M0 HCC treated with SBRT or RFA

23
Q

What regimen was included in the Michigan study comparing SBRT and RFA for inoperable HCC (Wahl et al. JCO 2015)?

A

Retrospective analysis of SBRT vs. RFA on FFLP and toxicity

24
Q

What were the results of the Michigan study comparing SBRT and RFA for inoperable HCC (Wahl et al. JCO 2015)?

A

<div><br></br></div>

1-yr FFLP 97% SBRT vs. 84% RFA<br></br>2-yr FFLP 84% SBRT vs. 80% RFA<br></br><b>SBRT was better for tumors >2 cm</b><br></br>Acute grade 3+ toxicity 11% vs. 5% (nonsignificant but favoring SBRT)

25
Q

What was the clinical relevance of the Chinese meta-analysis analyzing addition of RT to TACE for unresectable HCC (Meng et al. Radiother Onc 2009)?

A

Showed that TACE+RT showed improved OS over TACE alone. Additional randomized trials are warranted.

26
Q

What population was included in the Chinese meta-analysis analyzing addition of RT to TACE for unresectable HCC (Meng et al. Radiother Onc 2009)?

A

1476 pts with unresectable HCC

27
Q

What regimen was included in the Chinese meta-analysis analyzing addition of RT to TACE for unresectable HCC (Meng et al. Radiother Onc 2009)?

A

17 trials, 5 of which were randomized evaluating TACE vs. TACE+RT

28
Q

What were the results of the Chinese meta-analysis analyzing addition of RT to TACE for unresectable HCC (Meng et al. Radiother Onc 2009)?

A

TACE+RT has significantly improved OS over TACE alone

ANKI- GI (8 decks)

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