title: Long-term effect of stereotactic body radiation therapy for primary hepatocellular carcinoma ineligible for local ablation therapy or surgical resection. Stereotactic radiotherapy for liver cancer.
abstract: BACKGROUND
  We evaluated the long-term effect of stereotactic body radiation therapy (SBRT) for primary small hepatocellular carcinoma (HCC) ineligible for local therapy or surgery.
  
  
  METHODS
  Forty-two HCC patients with tumors ≤ 100 cc and ineligible for local ablation therapy or surgical resection were treated with SBRT: 30-39 Gy with a prescription isodose range of 70-85% (median 80%) was delivered daily in three fractions. Median tumor volume was 15.4 cc (3.0-81.8) and median follow-up duration 28.7 months (8.4-49.1).
  
  
  RESULTS
  Complete response (CR) for the in-field lesion was initially achieved in 59.6% and partial response (PR) in 26.2% of patients. Hepatic out-of-field progression occurred in 18 patients (42.9%) and distant metastasis developed in 12 (28.6%) patients. Overall in-field CR and overall CR were achieved in 59.6% and 33.3%, respectively. Overall 1-year and 3-year survival rates were 92.9% and 58.6%, respectively. In-field progression-free survival at 1 and 3 years was 72.0% and 67.5%, respectively. Patients with smaller tumor had better in-field progression-free survival and overall survival rates (<32 cc vs. ≥32 cc, P < 0.05). No major toxicity was encountered but one patient died with extrahepatic metastasis and radiation-induced hepatic failure.
  
  
  CONCLUSIONS
  SBRT is a promising noninvasive-treatment for small HCC that is ineligible for local treatment or surgical resection.
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Kwon
authors.forename: Si Hyun
authors.initials: SH
authors.lastname: Bae
authors.forename: Ji Yoon
authors.initials: JY
authors.lastname: Kim
authors.forename: Byung Ock
authors.initials: BO
authors.lastname: Choi
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Jang
authors.forename: Jeong Won
authors.initials: JW
authors.lastname: Jang
authors.forename: Jong Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Seung Kew
authors.initials: SK
authors.lastname: Yoon
authors.forename: Kyu Won
authors.initials: KW
authors.lastname: Chung
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D009367:Neoplasm Staging; D016634:Radiosurgery; D015996:Survival Rate; D013995:Time; D016896:Treatment Outcome
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