title: Therapeutic benefit of radiotherapy in huge (≥10 cm) unresectable hepatocellular carcinoma.
abstract: OBJECTIVE
  Huge (≥10 cm) hepatocellular carcinomas (HCCs) show dismal prognosis and only a limited number of cases are eligible for curative resection. We studied the therapeutic benefit of radiotherapy (RT) in patients with huge unresectable HCCs.
  
  
  METHODS
  Data from 283 patients with huge HCCs and preserved liver function who underwent non-surgical treatment from July 2001 to March 2012 were retrospectively reviewed. Patients were divided into 4 groups according to the initial treatment: Group A (N= 49), transarterial chemoembolization (TACE); Group B (N = 35), TACE + RT; Group C (N = 50), hepatic arterial infusion chemotherapy; and Group D (n = 149), concurrent chemoradiotherapy (CCRT).
  
  
  CONCLUSIONS
  The median follow-up period was 27.8 months (range, 12.9-121.9 months). The median overall survival (OS) was longer in Groups B (15.3 months) and D (12.8 months) than in Groups A (7.5 months) and C (8.2 months; Group B vs. A, Bonferroni corrected P [P(c)] = 0.04; Group B vs. C, P(c) = 0.02; Group D vs. A, P(c) = 0.01; Group D vs. C, Pc = 0.006). Groups B and D also showed superior progression-free survival (PFS) and intrahepatic control than Groups A and C. In multivariate analysis, tumour multiplicity, serum alpha-foetoprotein level (≥200 ng/ml) and initial treatment were independent prognostic factors for OS and PFS. Patients with huge unresectable HCCs treated with RT, either as CCRT or in combination with TACE, showed excellent intrahepatic control and prolonged survival. RT could be considered a promising treatment modality in these patients.
authors: Departments of Radiation Oncology, Yonsei Liver Cancer Special Clinic, Yonsei University Health System, Seoul, Korea.
authors: Kyung Hwan
authors: KH
authors: Kim
authors: Mi Sun
authors: MS
authors: Kim
authors: Jee Suk
authors: JS
authors: Chang
authors: Kwang-Hyub
authors: KH
authors: Han
authors: Do Young
authors: DY
authors: Kim
authors: Jinsil
authors: J
authors: Seong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
keywords: huge hepatocellular carcinoma; radiotherapy; survival; unresectable