title: Preliminary result of stereotactic body radiotherapy as a local salvage treatment for inoperable hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate the toxicity and efficacy of stereotactic body radiotherapy (SBRT) for the treatment of localized hepatocellular carcinoma (HCC) in the absence of another standard treatment option.
  
  
  METHODS
  The authors reviewed the details of 38 patients with inoperable HCC (diameter <10 cm) treated by SBRT in a prospectively registered database at their institution. All patients had been treated by transcatheter arterial chemoembolization before SBRT, which had been finally deemed ineffective. SBRT dosages (33-57 Gy in three or four fractions) were administered according to tumor volumes, which ranged from 11 to 464 ml (median, 40.5 ml).
  
  
  RESULTS
  Two-year overall survival and local progression-free survival rates were 61.4% and 66.4%, respectively. The local response rate was 63% at 3 months after SBRT. A high radiation dose was found to be independently related to survival. A decline in liver function was observed in six patients (16%) and Grade 3 musculoskeletal toxicity in one patient (2.7%).
  
  
  CONCLUSIONS
  This study showed that SBRT can be safely administered to select HCC patients, and these results suggest that this technique should be considered a salvage treatment. A further well-controlled large-scale study and longer follow-up are needed to determine optimal dose-fraction schedules and characterize late complications.
authors.affiliation: Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Nowon-gu, Seoul, Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Mi-Sook
authors.initials: MS
authors.lastname: Kim
authors.forename: Sung Yul
authors.initials: SY
authors.lastname: Yoo
authors.forename: Chul Koo
authors.initials: CK
authors.lastname: Cho
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Choi
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Chul Ju
authors.initials: CJ
authors.lastname: Han
authors.forename: Su Cheol
authors.initials: SC
authors.lastname: Park
authors.forename: Byung Hee
authors.initials: BH
authors.lastname: Lee
authors.forename: Young Han
authors.initials: YH
authors.lastname: Kim
authors.forename: Dong Han
authors.initials: DH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016879:Salvage Therapy; D017211:Treatment Failure