Matrix Metalloproteinase-2 and High Vascular Endothelial Growth Factor as Prognostic Markers for Intrahepatic Tumor Recurrence in Hepatocellular Carcinoma Patients Receiving Radiotherapy

摘要

Hepatocellular carcinoma (HCC) is a highly vascularized tumor. In this study, we investigated the prognostic and predictive value of these pro-angiogenic factors in HCC patients receiving radiotherapy. Between September 2008 and December 2009, a total of 50 patients treated with radiotherapy were prospectively enrolled. Patients' serum and urine were collected <1 week before and after. After completion of radiotherapy, serum VEGF/platelet levels were significantly increased (p < 0.01). Patients who experienced hepatic tumor recurrence outside the radiation field showed higher pre- and post-radiotherapy VEGF-A/platelet compared with patients who did not (p = 0.04), whereas patients who had hepatic tumor recurrence inside the radiation field showed significantly higher preradiotherapy MMP-2 (p = 0.04). On multivariate analyses, high pre-radiotherapy levels of either VEGF/platelet or MMP-2 (>= median) was a significant independent prognostic factor for worse progression-free survival (p = 0.04).In HCC patients receiving radiotherapy, pre-radiotherapy levels of VEGF/platelet and MMP-2 can be useful to predict treatment outcome. This study also suggests the necessity of antiangiogenic therapy such as sorafenib, since radiotherapy increase VEGF/platelet levels and higher levels of VEGF/platelet are associated with poor outcomes.