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.
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.
Kwon
Jung Hyun
JH
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Bae
Si Hyun
SH
Kim
Ji Yoon
JY
Choi
Byung Ock
BO
Jang
Hong Seok
HS
Jang
Jeong Won
JW
Choi
Jong Young
JY
Yoon
Seung Kew
SK
Chung
Kyu Won
KW
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
Clin Oncol (R Coll Radiol). 2008 Feb;20(1):69-75
17900882
Int J Radiat Oncol Biol Phys. 2009 Jun 1;74(2):412-8
18963538
Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):243-50
15668501
Int J Radiat Oncol Biol Phys. 1999 Jan 15;43(2):393-7
10030267
Int J Radiat Oncol Biol Phys. 2000 Jul 15;47(5):1331-5
10889387
J Clin Oncol. 2001 Jan 1;19(1):164-70
11134209
Aliment Pharmacol Ther. 2005 Jul 1;22(1):17-22
15963075
Strahlenther Onkol. 2001 Dec;177(12):645-55
11789403
J Hepatol. 2003;38 Suppl 1:S136-49
12591191
Int J Radiat Oncol Biol Phys. 2004 Mar 15;58(4):1114-20
15001252
Acta Oncol. 2006;45(7):831-7
16982547
Lancet Oncol. 2004 Sep;5(9):550-60
15337485
J Natl Cancer Inst. 2008 May 21;100(10):698-711
18477802
Radiology. 2005 Mar;234(3):954-60
15681691
Gastroenterology. 2004 Nov;127(5 Suppl 1):S27-34
15508094
Lancet. 2003 Dec 6;362(9399):1907-17
14667750
Stereotact Funct Neurosurg. 1997;69(1-4 Pt 2):124-8
9711744
Acta Oncol. 1995;34(6):861-70
7576756
Int J Radiat Oncol Biol Phys. 2000 Apr 1;47(1):13-47
10758303
Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1341-6
7713792
Cancer Cell. 2004 Mar;5(3):215-9
15050913
Int J Radiat Oncol Biol Phys. 2008 Nov 1;72(3):678-86
18395362
Hepatol Res. 2008 Jan;38(1):60-9
17506837
BMC Cancer. 2008 Nov 27;8:351
19038025
Acta Oncol. 2006;45(7):838-47
16982548
Int J Radiat Oncol Biol Phys. 2005 Aug 1;62(5):1371-8
16029795
Hepatology. 2005 Nov;42(5):1208-36
16250051
Expert Rev Anticancer Ther. 2007 Nov;7(11):1507-15
18020920
J Clin Oncol. 2008 Feb 1;26(4):657-64
18172187