Impact of pretreatment cholinesterase level on survival of inoperable intrahepatic or hepatic-hilar carcinomas treated with three-dimensional conformal radiotherapy.
OBJECTIVE
Prognostic factors for inoperable hepatocellular carcinomas (HCC), intrahepatic cholangiocellular carcinomas (IHCC), and hepatic-hilar cholangiocellular carcinomas (HHCC) treated with three-dimensional conformal radiotherapy (3DCRT) were evaluated.


METHODS
Thirty-five consecutive patients were treated with 3DCRT (HCC, 14; IHCC, 11; HHCC, 10). Doses of 3DCRT ranged from 30-70 Gy (mean, 51.5 Gy). The follow-up time of the 12 living patients was 5-39 (median, 11) months.


RESULTS
Two-year overall survival rates of HCC, IHCC, and HHCC were 19%, 26%, and 39%, respectively. On univariate analysis, 3DCRT dose (<50 Gy vs. 50-54 Gy vs. > or =60 Gy) (p<0.01) and pre-3DCRT cholinesterase value (p<0.01) were statistically significant factors for survival. Two-year overall survival rates of the patients treated with <50 Gy, 50-54 Gy, and > or =60 Gy were 0%, 50%, and 17%, respectively. The difference in survival between patients given 50-54 Gy and > or =60 Gy was not statistically significant (p=0.13). Two-year overall survival rates of patients with higher and lower cholinesterase values were 43% and 0%, respectively. On multivariate analysis, the independent variable most predictive of survival was pre-3DCRT cholinesterase value (p<0.01).


CONCLUSIONS
Pre-3DCRT cholinesterase value was a significant independent prognostic indicator for survival. Benefit of dose escalation above 60 Gy could not be demonstrated.
Hamamoto
Yasushi
Y
Department of Radiology, Sikoku Cancer Center, 13 Horinouchi, Matsuyama City, Ehime 790-0007, Japan.
Niino
Keiji
K
Ishiyama
Hiromichi
H
Hosoya
Takaaki
T
D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000532:radiotherapy*; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000532:radiotherapy*; D002802:Cholinesterases / Q000097:blood*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
D002802:Cholinesterases