{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T22:17:59Z","timestamp":1789510679309,"version":"build-2803163510"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Surgical resection is the primary treatment for HCC; however, it is associated with a high rate of recurrence and death. We conducted this phase 2 study to investigate the efficacy and safety of postoperative intensity\u2010modulated radiotherapy (IMRT) for HCC after narrow\u2010margin hepatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results<\/jats:title>\n                    <jats:p>We designed a single\u2010arm, prospective phase 2 trial to evaluate overall survival (OS), disease\u2010free survival (DFS), recurrence patterns, and toxicity in patients receiving adjuvant radiotherapy. The eligibility criteria included the following: pathological diagnosis of HCC after hepatectomy, with narrow pathological margins (&lt; 1 cm); age &gt; 18 years; and Eastern Cooperative Oncology Group performance status score of 0 or 1. Patients received IMRT within 4\u20106 weeks after surgical resection. This trial was registered at ClinicalTrials.gov (NCT01456156). Between 2008 and 2016, a total of 76 eligible patients who underwent narrow\u2010margin resection were enrolled. The median follow\u2010up duration was 70 months; the 3\u2010year OS and DFS rates were 88.2% and 68.1%, respectively; and the 5\u2010year OS and DFS rates were 72.2% and 51.6%, respectively. Intrahepatic recurrence was the primary recurrence pattern. No marginal recurrence was found. Intrahepatic, extrahepatic, and combined recurrences at the first relapse were found in 33, 5, and 1 patient, respectively. The most common radiation\u2010related grade\u20103 toxicities were leukopenia (7.9%), elevated alanine aminotransferase (3.9%) and aspartate aminotransferase (2.6%) levels, and thrombocytopenia (1.3%). Classical or nonclassical radiation\u2010induced liver disease was not noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adjuvant radiotherapy is an effective, well\u2010tolerated, and promising adjuvant regimen in patients with HCC who have undergone narrow\u2010margin hepatectomy. Our trial provides evidence and a rationale for planning a future phase 3 trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.31993","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T16:35:33Z","timestamp":1623170133000},"page":"2595-2604","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":72,"title":["Phase 2 Study of Adjuvant Radiotherapy Following Narrow\u2010Margin Hepatectomy in Patients With HCC"],"prefix":"10.1097","volume":"74","author":[{"given":"Bo","family":"Chen","sequence":"first","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0418-405X","authenticated-orcid":false,"given":"Li\u2010Ming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Qi","family":"Rong","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010Lian","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Jin","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue\u2010Ping","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong\u2010Wen","family":"Song","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Ren","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Fang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Tang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0985-235X","authenticated-orcid":false,"given":"Ye\u2010Xiong","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital,Chinese Academy of Medical Sciences, and Peking Union Medical College,Beijing,P. R. 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