Phase II trial of palliative radiotherapy for hepatocellular carcinoma and liver metastases.
OBJECTIVE
To evaluate the feasibility and response of liver radiotherapy (RT) in improving symptoms and quality of life in patients with hepatocellular carcinoma (HCC) or liver metastases (LM).


METHODS
Eligible patients had HCC or LM, unsuitable for or refractory to standard therapies, with an index symptom of pain, abdominal discomfort, nausea, or fatigue. The Brief Pain Inventory (BPI), Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep), and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) were completed by patients at baseline and each follow-up. The primary outcome was the percentage of patients with a clinically significant change at 1 month in the BPI subscale of symptom on average in the past 24 hours. Secondary outcomes were improvement in other BPI subscales and at other time points, FACT-Hep and EORTC QLQ-C30 at each follow-up, and toxicity at 1 week.


RESULTS
Forty-one patients (30 men and 11 women) with HCC (n = 21) or LM (n = 20) were accrued. At 1 month, 48% had an improvement in symptom on average in the past 24 hours. Fifty-two percent of patients had improvement in symptom at its worst, 37% at its least, and 33% now. Improvements in the FACT-G and hepatobiliary subscale were seen in 23% and 29% of patients, respectively, at 1 month. There were also improvements in EORTC QLQ-C30 functional (range, 11% to 21%) and symptom (range, 11% to 50%) domains. One patient developed grade 3 nausea at 1 week.


CONCLUSIONS
Improvements in symptoms were observed at 1 month in a substantial proportion of patients. A phase III study of palliative liver RT is planned. [Corrected]
Hany Soliman, Odette Sunnybrook Cancer Centre, University of Toronto; Jolie Ringash, Haiyan Jiang, John Kim, Robert Dinniwell, Anthony Brade, Rebecca Wong, James Brierley, Bernard Cummings, Camilla Zimmermann, and Laura A. Dawson, Princess Margaret Cancer Centre, University of Toronto; and Jolie Ringash and Kawalpreet Singh, University of Toronto, Toronto, Ontario, Canada.
Hany
H
Soliman
Jolie
J
Ringash
Haiyan
H
Jiang
Kawalpreet
K
Singh
John
J
Kim
Robert
R
Dinniwell
Anthony
A
Brade
Rebecca
R
Wong
James
J
Brierley
Bernard
B
Cummings
Camilla
C
Zimmermann
Laura A
LA
Dawson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome