title: Outcomes following definitive stereotactic body radiotherapy for patients with Child-Pugh B or C hepatocellular carcinoma.
abstract: OBJECTIVE
  To report outcomes in patients with Child-Pugh B or C (CP B/C) hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT).
  
  
  METHODS
  A prospective study of SBRT was developed for patients with CP B7 or B8 unresectable HCC, <10 cm. Selected ineligible patients (e.g. CP>B8, >10 cm) treated off-study from 2004 to July 2012 were also reviewed. Patients were excluded if they were treated as a bridge-to-liver-transplant.
  
  
  RESULTS
  29 patients with CP B/C HCC were treated with SBRT (median dose 30 Gy in 6 fractions) from 2004 to December 2012. The majority had CP B7 liver function (69%) and portal vein tumor thrombosis (76%). The median survival was 7.9 months (95% CI: 2.8-15.1). Survival was significantly better in patients with CP=B7 and AFP≤4491 ng/mL. Of 16 evaluable patients, 63% had a decline in CP score by ≥2 points at 3 months.
  
  
  CONCLUSIONS
  SBRT is a treatment option for selected HCC patients with small HCCs and modestly impaired (CP B7) liver function.
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto; Department of Radiation Oncology, University of Toronto, Canada.
authors.forename: Shaelyn
authors.initials: S
authors.lastname: Culleton
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto; Department of Radiation Oncology, University of Toronto, Canada.
authors.forename: Carol R
authors.initials: CR
authors.lastname: Haddad
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto; Department of Radiation Oncology, University of Toronto, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Kim
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto; Department of Radiation Oncology, University of Toronto, Canada.
authors.forename: Jim
authors.initials: J
authors.lastname: Brierley
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto; Department of Radiation Oncology, University of Toronto, Canada.
authors.forename: Anthony
authors.initials: A
authors.lastname: Brade
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto; Department of Radiation Oncology, University of Toronto, Canada.
authors.forename: Jolie
authors.initials: J
authors.lastname: Ringash
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto; Department of Radiation Oncology, University of Toronto, Canada. Electronic address: Laura.Dawson@rmp.uhn.on.ca.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Dawson
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Child-Pugh B; Hepatocellular carcinoma; SBRT; Stereotactic body radiotherapy