title: Stereotactic body radiation therapy combined with transcatheter arterial chemoembolization for small hepatocellular carcinoma.
abstract: OBJECTIVE
  To compare the tumor control and safety of stereotactic body radiation therapy (SBRT) combined with transcatheter arterial chemoembolization (TACE) for small, solitary, and hypervascular hepatocellular carcinoma (HCC) with TACE alone.
  
  
  METHODS
  Three hundred and sixty-five HCC patients who had solitary, ≤ 3 cm, and hypervascular nodule were treated with TACE. Among them, 30 patients followed by SBRT (SBRT group) and 38 patients without additional therapy and previous HCC treatment (control group) were enrolled in this retrospective cohort study. Local tumor progression, complication, and disease-free survival were compared between these groups.
  
  
  RESULTS
  There was no difference in clinical background between these groups. Complete response to therapy was noted in 29 (96.3%) patients of the SBRT group, and in only one (3.3%) patient of the TACE group (P < 0.001). None of the patients developed acute hematologic toxicity of more than Common Terminology Criteria for Adverse Events Grade 3 during and after the treatment. Furthermore, none of the SBRT group developed radiation-induced liver damage. Disease-free survival of the 12 patients without previous HCC treatments in SBRT group was significantly superior to that in control group (15.7 months vs 4.2 months; P = 0.029).
  
  
  CONCLUSIONS
  The results indicated that SBRT combined with TACE is a safe and effective modality for locoregional treatment of small solitary primary HCC, and could be potentially a suitable option.
authors.affiliation: Department of Gastroenterology, Graduate School of Biomedical Sciences, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yohji
authors.initials: Y
authors.lastname: Honda
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kimura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Keiichi
authors.initials: K
authors.lastname: Masaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakahara
authors.forename: Noriaki
authors.initials: N
authors.lastname: Naeshiro
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ono
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyaki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nagaoki
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Shintaro
authors.initials: S
authors.lastname: Takaki
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.forename: Masaki
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kakizawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kenjo
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nagata
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D047368:Tumor Burden