Pilot study of stereotactic body radiotherapy for huge hepatocellular carcinoma unsuitable for other therapies.
OBJECTIVE
To determine the feasibility and efficacy of stereotactic body radiotherapy (SBRT) for huge hepatocellular carcinoma unsuitable for other therapies.


METHODS
Six patients with very large hepatocellular carcinomas (>10 cm) unsuitable for surgical resection or that failed to respond to transcatheter arterial chemoembolization (TACE) were treated by SBRT. Doses ranged from 32 Gy to 40 Gy in four fractions. Survival, response, and toxicities were evaluated.


RESULTS
After a median follow-up of 25.9 months (range 8.1-56 months), three patients had died and three were alive. Overall, treatment was well tolerated and no dose-limiting toxicity or radiation-induced liver disease was observed. The median survival was 10 months (range 3-56 months) and the median progression-free duration was 6 months (range, 2-21 months). Partial response was achieved by four patients, stable disease by one, and one patient had disease progression. One patient with a partial response who underwent lobectomy after SBRT was alive 56 months post-SBRT.


CONCLUSIONS
This study suggests that SBRT can be delivered safely at 32-40 Gy in four fractions to huge hepatocellular carcinoma. Furthermore, combinations of SBRT with other modalities such as surgery or TACE might prolong survival.
Shin
Young-Joo
YJ
Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
Kim
Mi-Sook
MS
Yoo
Seong Yul
SY
Cho
Chul Koo
CK
Seo
Young Seok
YS
Kang
Jin-kyu
JK
Park
Su Cheol
SC
Han
Chul Ju
CJ
Kim
Sang Beom
SB
Lee
Byong Hee
BH
Lees
Dong Han
DH
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000532:radiotherapy*; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D016634:Radiosurgery / Q000009:adverse effects; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D016896:Treatment Outcome