本系统性综述和荟萃分析报告了肝脏限定性肝细胞癌（HCC）经体重加调强放射治疗（SBRT）治疗后的结果和肝毒性率，并提出了关于适当患者管理的共识指南。按照《系统综述和荟萃分析备忘录》的指南，从Embase、MEDLINE、Cochrane和Scopus数据库中，使用关键词术语（"体重加调强放射治疗" OR "SBRT" OR "SABR" OR "体重加调强放射治疗"）AND（"肝细胞癌" OR "HCC"）进行了一项系统性综述，选择了截至2022年10月之前发表的至少5年的研究结果。利用加权随机效应模型进行了一项聚合数据（AD）荟萃分析，评估了整体生存率（OS）和局部控制率（LC）。此外，还进行了一项个体患者数据（IPD）分析，将来自6个机构的数据纳入其自身的亚组分析中。共纳入了17项观察性研究，包括1889例HCC患者，在2003年至2019年期间接受了≤9次SBRT分割治疗。SBRT治疗后的3年和5年OS率分别为57%（95%置信区间[CI]，47-66%）和40%（95% CI，29-51%）。SBRT治疗后的3年和5年LC率分别为84%（95% CI，77-90%）和82%（95% CI，74-88%）。肿瘤大小是影响LC的唯一预后因素。肿瘤大小和区域与OS显著相关。 IPD分析显示，5年LC和OS率分别为79%（95% CI，0.74-0.84）和25%（95% CI，0.20-0.30）。对于改善OS的预后因素包括肿瘤大小<3 cm、东部地区、Child-Pugh评分≤B7以及巴塞罗那肝癌诊所分期为0和A。严重肝毒性的发生率因应用标准而异。SBRT是成熟随访下的HCC患者的有效治疗方法。XXX代表开发了临床实践指南。版权所有 © 2023. Elsevier Inc. 发表。

This systematic review and meta-analysis reports on outcomes and hepatic toxicity rates following stereotactic body radiotherapy (SBRT) for liver confined hepatocellular carcinoma (HCC), and presents consensus guidelines regarding appropriate patient management.Using the Preferred Reporting Items for Systemic Review and Meta-analyses guidelines, a systematic review was performed from articles reporting outcomes at ≥5 years published prior to October 2022 from the Embase, MEDLINE, Cochrane, and Scopus databases using the key words terms ("Stereotactic body radiotherapy" OR "SBRT" OR "SABR" OR "Stereotactic ablative radiotherapy") AND ("Hepatocellular carcinoma" OR "HCC"). An aggregated data (AD) meta-analysis was conducted to assess overall survival (OS) and local control (LC) using weighted random effects models. In addition, an individual patient data (IPD) analysis incorporating data from 6 institutions was conducted as its own subgroup analyses.Seventeen observational studies, comprising 1889 HCC patients treated with ≤9 SBRT fractions, between 2003 and 2019, were included in the AD meta-analysis. The 3- and 5- year OS rates after SBRT were 57% (95% confidence interval [CI], 47-66%) and 40% (95% CI, 29-51%). The 3- and 5- year LC rates after SBRT were 84% (95% CI, 77-90%) and 82% (95% CI, 74-88%), respectively. Tumor size was the only prognostic factor for LC. Tumor size and region were significantly associated with OS. Five-year LC and OS rates of 79% (95% CI, 0.74-0.84) and 25% (95% CI, 0.20-0.30), respectively, were observed in the IPD analyses. Factors prognostic for improved OS were tumor size <3 cm, eastern region, Child-Pugh score ≤B7, and the Barcelona Clinic Liver Cancer stage of 0 and A. The incidence of severe hepatic toxicity varied according to the criteria applied.SBRT is an effective treatment modality for HCC patients with mature follow up. Clinical practice guidelines were developed on behalf of the XXXX.Copyright © 2023. Published by Elsevier Inc.