SBRT for bridging and downstaging HCC before transplant
Bibliographic record
Abstract
Background & Aims: Stereotactic body radiotherapy (SBRT) has emerged as a bridging/downstaging therapy for patients with hepatocellular carcinoma (HCC) awaiting liver transplantation (LT). This study evaluates the safety and outcomes of the use of SBRT in such patients. Methods: A retrospective review was conducted from 2004 to 2019 on 88 adult patients with HCC receiving SBRT as bridging/downstaging therapy. Endpoints, included treatment-related toxicities, liver function decline, and LT probability post SBRT, were analyzed using competing risk analysis. Results: 7%, 15%, and 17% at 1, 3, and 5 years, respectively). Explant pathology revealed a 25% complete pathological response rate (bridging, 30%; downstaging, 12%). Conclusions: Our results showed that SBRT is a safe and effective bridging therapy for HCC. However, its role in downstaging is limited by lower response rates and higher recurrence, emphasizing the importance of patient selection. Impact and implications: SBRT is an emerging therapy for patients with HCC awaiting LT, with limited data available on its safety and efficacy. Our study provides crucial insights for physicians and researchers, demonstrating that SBRT is a safe and effective option for bridging patients with HCC to transplantation. These findings are important for optimizing treatment strategies and providing patients with additional therapeutic options while awaiting transplantation. However, the lower response rates and higher recurrence in the downstaging group highlight the need for further research to improve patient selection and tailor treatments for optimal outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".