title: Radiation therapy for lymph node metastases from hepatocellular carcinoma.
abstract: OBJECTIVE
  Recent improvements in the prognosis of patients with hepatocellular carcinoma (HCC) render the discovery and treatment of lymph node (LN) metastasis increasingly important. We retrospectively evaluated the treatment outcomes of radiation therapy (RT) for LN metastases from HCC.
  
  
  METHODS
  Twenty-three patients with LN metastases from HCC underwent RT. A daily dose of 1.8-4 Gy was administered to deliver a total dose of 28-56 Gy, which was a biologic effective dose (BED) of 36-67.2 Gy10 (median 58.5 Gy10) with an alpha/beta ratio of 10. We evaluated predictive factors for local control and survival.
  
  
  RESULTS
  A complete response and partial response were recorded for 5 and 14 patients, respectively. The response rate was 83%; it was significantly higher in patients who had received > or =58 Gy10 rather than <58 Gy10 (P = 0.014). The median survival time was 19 months. Univariate analysis revealed that the Child-Pugh's classification, status of the liver tumor, and LN metastasis site were significant factors for survival. Multivariate analysis showed that the status of the liver tumor was the only independent predictor of survival.
  
  
  CONCLUSIONS
  RT is effective for the local control of LN metastases from HCC without a confirmed survival effect. RT doses greater than 58 Gy10 are required for a better local response.
authors: Department of Radiation Oncology, Kumamoto University Hospital, Japan. ryo108@m9.dion.ne.jp
authors: Ryo
authors: R
authors: Toya
authors: Ryuji
authors: R
authors: Murakami
authors: Tadamasa
authors: T
authors: Yasunaga
authors: Yuji
authors: Y
authors: Baba
authors: Ryuichi
authors: R
authors: Nishimura
authors: Shoji
authors: S
authors: Morishita
authors: Junko
authors: J
authors: Nishi
authors: Toru
authors: T
authors: Beppu
authors: Hideo
authors: H
authors: Baba
authors: Yasuyuki
authors: Y
authors: Yamashita
authors: Natsuo
authors: N
authors: Oya
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy* / Q000556:secondary; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome