title: Treatment outcomes of helical intensity-modulated radiotherapy for unresectable hepatocellular carcinoma.
abstract: OBJECTIVE
  This study reports treatment outcomes after helical intensity-modulated radiotherapy (IMRT) in unresectable hepatocellular carcinoma (HCC) patients for whom transarterial chemoembolization (TACE) was considered ineffective or unsuitable.
  
  
  METHODS
  From January 2008 to December 2011, 22 unresectable HCC patients received helical IMRT. A daily dose of 1.8 to 4 Gy was delivered at five fractions per week to deliver a total dose of 30 to 60 Gy. The most-prescribed dose fractionation was a total dose of 50 to 57.5 Gy, with a daily dose of 2.3 to 2.5 Gy.
  
  
  RESULTS
  In the entire group, the objective response rate of the primary tumor was 72.7%. In the eight patients with portal vein thrombosis (PVT), the objective response rate of PVT was 50.0%. Median disease progression-free survival was 11.8 months, and the 1-year disease progression-free survival rate was 40.2%. The median overall survival was 14.4 months, and the 1- and 2-year overall survival rates were 86.4% and 69.1%, respectively. PVT and Child-Pugh classifications were significant prognostic factors for overall survival in multivariate analyses.
  
  
  CONCLUSIONS
  Helical IMRT in patients with unresectable HCC resulted in high treatment response and survival rates. This study suggests helical IMRT is a practical treatment option for HCC patients in whom TACE is unsuitable or ineffective.
authors.affiliation: Department of Radiation Oncology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Moonkyoo
authors.initials: M
authors.lastname: Kong
authors.forename: Seong Eon
authors.initials: SE
authors.lastname: Hong
authors.forename: Woo Suk
authors.initials: WS
authors.lastname: Choi
authors.forename: Jinhyun
authors.initials: J
authors.lastname: Choi
authors.forename: Youngkyong
authors.initials: Y
authors.lastname: Kim
keywords: Helical intensity-modulated radiotherapy; Hepatocellular carcinoma; Objective response rate; Prognostic factor; Survival rate