Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2024; 16(6): 1601-1608
Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1601
Clinical efficacy of Gamma Knife® combined with transarterial chemoembolization and immunotherapy in the treatment of primary liver cancer
Guo-Feng Wang, Chang-Xin Shu, Xiao-Dong Cai, Hong-Bo Wang, Jian-Hong Xu, Yu-Qing Jia
Guo-Feng Wang, Chang-Xin Shu, Xiao-Dong Cai, Hong-Bo Wang, Jian-Hong Xu, Yu-Qing Jia, Department of General Surgery, Yangzhou Friendship Hospital Affiliated to Medical College of Yangzhou University, Yangzhou 225000, Jiangsu Province, China
Co-first authors: Guo-Feng Wang and Chang-Xin Shu.
Author contributions: Wang GF and Shu CX contributed equally to this work and are co-first authors, including design of the study, acquiring and analyzing data from experiments, and writing of the actual manuscript; Wang GF, Shu CX, and Jia YQ designed the experiment and conducted clinical data collection; Cai XD and Wang HB performed postoperative follow-up and recorded data; Wang GF, Shu CX, Xu JH, and Jia YQ conducted a number of collation and statistical analysis; and all the authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Yangzhou Friendship Hospital Affiliated to Medical College of Yangzhou University.
Informed consent statement: The ethics committee agrees to waive informed consent.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Qing Jia, MD, Doctor, Department of General Surgery, Yangzhou Friendship Hospital Affiliated to Medical College of Yangzhou University, No. 446 Siwangting Road, Hanjiang District, Yangzhou 225000, Jiangsu Province, China. 13605251826@163.com
Received: February 19, 2024
Revised: March 21, 2024
Accepted: April 23, 2024
Published online: June 27, 2024
Processing time: 132 Days and 0.2 Hours
Abstract
BACKGROUND

This study was designed to investigate the clinical efficacy and safety of Gamma Knife® combined with transarterial chemoembolization (TACE) and immunotherapy in the treatment of primary liver cancer.

AIM

To investigate the clinical efficacy and safety of Gamma Knife® combined with TACE and immune-targeted therapy in the treatment of primary liver cancer.

METHODS

Clinical data from 51 patients with primary liver cancer admitted to our hospital between May 2018 and October 2022 were retrospectively collected. All patients underwent Gamma Knife® treatment combined with TACE and immunotherapy. The clinical efficacy, changes in liver function, overall survival (OS), and progression-free survival (PFS) of patients with different treatment responses were evaluated, and adverse reactions were recorded.

RESULTS

The last follow-up for this study was conducted on October 31, 2023. Clinical evaluation of the 51 patients with primary liver cancer revealed a partial response (PR) in 27 patients, accounting for 52.94% (27/51); stable disease (SD) in 16 patients, accounting for 31.37% (16/51); and progressive disease (PD) in 8 patients, accounting for 15.69% (8/51). The objective response rate was 52.94%, and the disease control rate was 84.31%. Alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and alpha-fetoprotein isoform levels decreased after treatment compared with pretreatment (all P = 0.000). The median OS was 26 months [95% confidence interval (95%CI): 19.946-32.054] in the PR group and 19 months (95%CI: 14.156-23.125) in the SD + PD group, with a statistically significant difference (P = 0.015). The median PFS was 20 months (95%CI: 18.441-34.559) in the PR group and 12 months (95%CI: 8.745-13.425) in the SD + PD group, with a statistically significant difference (P = 0.002). Common adverse reactions during treatment included nausea and vomiting (39.22%), thrombocytopenia (27.45%), and leukopenia (25.49%), with no treatment-related deaths reported.

CONCLUSION

Gamma Knife® combined with TACE and immune-targeted therapy is safe and effective in the treatment of primary liver cancer and has a good effect on improving the clinical benefit rate and liver function of patients.

Keywords: Gamma Knife®; Transarterial chemoembolization; Immunotherapy; Primary liver cancer; Liver function

Core Tip: Most patients with primary liver cancer are diagnosed in the middle and late stage, and lose the best opportunity for surgical treatment. Transcatheter arterial chemoembolization (TACE), immune targeted therapy and gamma knife technology are all important methods for clinical treatment of liver cancer. This study mainly discusses the clinical efficacy of gamma knife combined with TACE and immune targeted therapy for primary liver cancer, and provides reference for clinical treatment.