Caren van Roekel

196 Chapter 7 FIGURE 4A,B*. ROC-curve showing the discriminative value of tumor-absorbed dose for response (a) and ROC-curve showing the ability of mean tumor-absorbed dose per patient to discriminate between patients with CR/PR versus StD/PD (b). *The AUCs are based on a clustered data analysis, however, the ROC-curves are not. Survival Median overall survival was 10.7 months (95% CI: 7.2 – 13.4). Survival was significantly different in patients without a metabolic response (including the development of new intra- or extrahepatic lesions) versus patients with a metabolic response (HR=2.34, 95% CI 1.09 - 5.69, p=0.029). After adjusting for tumor load, extrahepatic disease at baseline and parenchymal dose, the HR for non-responders was 2.54 (95% CI: 1.13 - 6.52, p=0.023). Median overall survival in responders was 14.8 months (95% CI 14.2 - ∞, n=8) versus 8.6 months (95% CI 6.4 – 13.4 months, n=29) in non-responders (Figure 5a-b). Furthermore, there was a significant difference in overall survival between patients with a mean tumor-absorbed dose >90 Gy versus a mean tumor-absorbed dose <90 Gy (HR=0.16, 95%CI 0.06-0.511), p=0.0031), Figure 6.