title: Stereotactic body radiation therapy with or without transarterial chemoembolization for patients with primary hepatocellular carcinoma: preliminary analysis.
abstract: BACKGROUND
  The objectives of this retrospective study was to evaluate the efficacy of stereotactic body radiation therapy (SBRT) for small non-resectable hepatocellular carcinoma (HCC) and SBRT combined with transarterial chemoembolization (TACE) for advanced HCC with portal vein tumor thrombosis (PVTT).
  
  
  METHODS
  Thirty one patients with HCC who were treated with SBRT were used for the study. We studied 32 HCC lesions, where 23 lesions (22 patients) were treated targeting small non-resectable primary HCC, and 9 lesions (9 patients) targeting PVTT using the Cyberknife. All the 9 patients targeting PVTT received TACE for the advanced HCC. Tumor volume was 3.6-57.3 cc (median, 25.2 cc) and SBRT dose was 30-39 Gy (median, 36 Gy) in 3 fractions for consecutive days for 70-85% of the planned target volume.
  
  
  RESULTS
  The median follow up was 10.5 months. The overall response rate was 71.9% [small HCC: 82.6% (19/23), advanced HCC with PVTT: 44.4% (4/9)], with the complete and partial response rates of 31.3% [small HCC: 26.1% (6/23), advanced HCC with PVTT: 11.1% (1/9)], and 50.0% [small HCC: 56.5% (13/23), advanced HCC with PVTT: 33.3% (3/9)], respectively. The median survival period of small HCC and advanced HCC with PVTT patients was 12 months and 8 months, respectively. No patient experienced Grade 4 toxicity.
  
  
  CONCLUSIONS
  SBRT for small HCC and SBRT combined with TACE for advanced HCC with PVTT showed feasible treatment modalities with minimal side effects in selected patients with primary HCC.
authors.affiliation: Department of Radiation Oncology, The Catholic University of Korea, School of Medicine, Seoul, South Korea. choibo67@catholic.ac.kr
authors.forename: Byung Ock
authors.initials: BO
authors.lastname: Choi
authors.forename: Ihl Bohng
authors.initials: IB
authors.lastname: Choi
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Jang
authors.forename: Young Nam
authors.initials: YN
authors.lastname: Kang
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Jang
authors.forename: Si Hyun
authors.initials: SH
authors.lastname: Bae
authors.forename: Seung Kew
authors.initials: SK
authors.lastname: Yoon
authors.forename: Gyu Young
authors.initials: GY
authors.lastname: Chai
authors.forename: Ki Mun
authors.initials: KM
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome