title: The efficacy of high-dose 3-dimensional conformal radiation therapy in patients with small hepatocellular carcinoma not eligible for other local modalities.
abstract: OBJECTIVE
  To analyze the efficacy and toxicity of high-dose 3-dimensional conformal radiation therapy (3D-CRT) for patients with small hepatocellular carcinoma (HCC) not eligible for other local modalities.
  
  
  METHODS
  Between 1998 and 2006, 61 patients with small HCC were treated with high-dose 3D-CRT. The eligibility criteria were as follows: (1) HCC <5 cm; (2) HCC without vascular invasion; (3) HCC without extrahepatic metastasis; and (4) not eligible for other local modalities. The median RT dose was 54 Gy (range, 36 to 55 Gy) daily in 2.5 to 5 Gy fractions. We evaluated tumor response, local control, overall survival, pattern of failure, and toxicity.
  
  
  RESULTS
  The median follow-up period was 16.7 months. Tumor response was 68.9% (42 of 61 lesions) with a complete response in 27 lesions (44.3%). Local control was 93.8% at 1 year and 86.9% at 3 years. Intrahepatic metastases developed in 40 patients (65.6%). Thirteen patients (22.3%) had extrahepatic metastasis. The median survival was 56 months (range, 2.8 to 68.1 mo), and the overall survival rate was 81.1% at 1 year and 58.4% at 3 years. Three patients developed radiation-induced liver disease, but there were no instances of grade 3 or higher toxicity.
  
  
  CONCLUSIONS
  High-dose 3D-CRT for small HCC <5 cm showed favorable local control and overall survival without serious complications. RT might be an effective local modality in patients with small HCC not eligible for other local modalities.
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea.
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Lim
authors.forename: Hyebin
authors.initials: H
authors.lastname: Lee
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Park
authors.forename: Jung Ae
authors.initials: JA
authors.lastname: Lee
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoo
authors.forename: Kwang Cheol
authors.initials: KC
authors.lastname: Koh
authors.forename: Joon Hyeok
authors.initials: JH
authors.lastname: Lee
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Choi
authors.forename: Geum Youn
authors.initials: GY
authors.lastname: Gwak
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome