title: Bone metastasis from primary hepatocellular carcinoma: characteristics of soft tissue formation.
abstract: OBJECTIVE
  To assess the characteristics of bone metastasis from hepatocellular carcinoma and the radiation field arrangement based on imaging studies.
  
  
  METHODS
  Fifty-three patients (84 lesions) with bone metastasis from a primary hepatocellular carcinoma completed palliative radiation therapy. All patients underwent one of following imaging studies prior to the initiation of radiation therapy: a bone scan, computed tomography or magnetic resonance imaging. The median radiation dose was 30 Gy (7 approximately 40 Gy). We evaluated retrospectively the presence of soft tissue formation and the adjustment of the radiation field based on the imaging studies.
  
  
  RESULTS
  Soft tissue formation at the site of bony disease was identified from either a CT/MRI scan (41 lesions) or from a symptomatic palpable mass (5 lesions). The adjustment of the radiation field size based on a bone scan was necessary for 31 of 41 soft tissue forming lesions (75.6%), after a review of the CT/MRI scan. The median survival from the initial indication of a hepatoma diagnosis was 8 months (2 to 71 months), with a 2-year survival rate of 38.6%. The median survival from the detection of a bone metastasis was 5 months (1 to 38 months) and the 1-year overall survival rate was 8.7%.
  
  
  CONCLUSIONS
  It was again identified that bone metastasis from a primary hepatocellular carcinoma is accompanied by soft tissue formation. From this finding, an adjustment of the radiation field size based on imaging studies is required. It is advisable to obtain a CT or MRI scan of suspected bone metastasis for better tumor volume coverage prior to the initiation of radiation therapy.
authors.affiliation: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Sangwon
authors.initials: S
authors.lastname: Kim
authors.forename: Mison
authors.initials: M
authors.lastname: Chun
authors.forename: Heejung
authors.initials: H
authors.lastname: Wang
authors.forename: Sungwon
authors.initials: S
authors.lastname: Cho
authors.forename: Young-Taek
authors.initials: YT
authors.lastname: Oh
authors.forename: Seung-Hee
authors.initials: SH
authors.lastname: Kang
authors.forename: Juno
authors.initials: J
authors.lastname: Yang