Patterns of care and outcomes of definitive external beam radiotherapy and radioembolization for localized hepatocellular carcinoma: A propensity score-adjusted analysis.

329Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality worldwide. Most patients with localized HCC are not surgically operable or transplantation candidates, thus there is an increasing role for nonsurgical locoregional therapies. Ablative external beam radiotherapy (XRT) and transarterial radioembolization (TARE) are two emerging radiotherapeutic treatments for localized HCC. However, there are little data comparing their efficacy. We therefore sought to evaluate their utilization and efficacy in a large nationwide cohort. Methods: We conducted an observational study of 2,685 patients from the National Cancer Database diagnosed with American Joint Committee on Cancer 7th edition clinical stage I-III HCC between 2004-2015, treated with definitive-intent XRT delivered in 1-15 fractions or TARE. The association between treatment modality (XRT versus TARE [referent]) and overall survival (OS) was defined using propensity score-weighted Kaplan-Meier estimators and propensity scor...