A retrospective study of radiotherapy for spinal bone metastases from hepatocellular carcinoma (HCC).
OBJECTIVE
To evaluate the therapeutic effects of radiotherapy on spinal bone metastases from hepatocellular carcinoma (HCC).


METHODS
A retrospective review was conducted on 24 ambulatory patients with spinal bone metastases from HCC treated by radiotherapy from 1995 to 2004. Ambulatory rate and local progression-free rate after radiotherapy were analyzed. Eight (33%) of 24 patients had radiographic spinal cord compression from the spinal bone metastases before the treatment. Two (8.3%) of the 24 patients had some spinal deficits before the treatment. Biological equivalent dose (BED) with alpha/beta ratios of 10 ranged from 39 to 50.7 Gy (median 44.8 Gy).


RESULTS
The median observation period was 5.1 months ranging from 0.9 to 36.0 months. Among the 24 patients, five (21%) underwent salvage therapies, while of the remaining 19 patients four (21%) became nonambulatory by the last follow-up. The ambulatory rates at 3 months and 6 months were 85 and 63%, respectively. The local progression-free rates at 3 months and 6 months were 53 and 47%, respectively.


CONCLUSIONS
Radiotherapy with a BED of 39-50.7 Gy (median 44.8 Gy) is not sufficiently effective for the patients with spinal bone metastases from HCC to prevent paralysis. Dose escalation with a highly precise radiation technique will need to be evaluated.
Nakamura
Naoki
N
Department of Radiology, Tokyo University Hospital, Tokyo, Japan. nnakamur-tky@umin.ac.jp
Igaki
Hiroshi
H
Yamashita
Hideomi
H
Shiraishi
Kenshiro
K
Tago
Masao
M
Sasano
Nakashi
N
Shiina
Syuichiro
S
Omata
Masao
M
Makuuchi
Masatoshi
M
Ohtomo
Kuni
K
Nakagawa
Keiichi
K
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy* / Q000556:secondary*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011881:Radiotherapy, Computer-Assisted; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D016019:Survival Analysis; D016138:Walking