title: Brain metastasis from hepatocellular carcinoma: The impact of radiotherapy on control of intracranial hemorrhage.
abstract: OBJECTIVE
  Brain metastasis from hepatocellular carcinoma (HCC) is rare and causes devastating outcomes with intracranial hemorrhage. We retrospectively analyzed the impact of radiotherapy in preventing hemorrhagic events among patients with brain metastasis from HCC.
  
  
  METHODS
  Patients who underwent treatment for brain metastasis from HCC at our cancer center between January 2003 and December 2012 were identified from a prospectively compiled hospital database. Clinical characteristics were analyzed in patients with and without radiotherapy.
  
  
  RESULTS
  Fifteen HCC patients with brain metastasis from HCC were classified into two groups: 11 patients underwent radiotherapy (group R) and four patients received best supportive care without radiotherapy (group N). Six patients (54.5%) in group R and four patients (100%) in group N showed intracranial hemorrhage at presentation of brain metastasis. No patients in group R experienced intracranial hemorrhage during follow up, although two patients in group N did. Median overall survival was 22.4 weeks (range, 5.42-69.1) in group R and 2.24 weeks (range, 1.0-15.4) in group N.
  
  
  CONCLUSIONS
  For patients with brain metastasis from HCC, radiotherapy appears useful for controlling brain lesions, preventing intracranial hemorrhage and improving survival. Radiotherapy may contribute to control of intracranial tumor and prevention of intracranial hemorrhage for selected patients with brain metastasis from HCC.
authors.affiliation: Division of Diagnostic Radiology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Yamakawa
authors.affiliation: Division of Diagnostic Radiology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
authors.forename: Michihisa
authors.initials: M
authors.lastname: Moriguchi
authors.affiliation: Division of Diagnostic Radiology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Aramaki
authors.affiliation: Division of Neurosurgery, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Mitsuya
authors.affiliation: Division of Diagnostic Radiology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
authors.forename: Koiku
authors.initials: K
authors.lastname: Asakura
authors.affiliation: Division of Diagnostic Radiology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sawada
authors.affiliation: Division of Diagnostic Radiology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Endo
authors.affiliation: Division of Neurosurgery, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nakasu
keywords: brain metastasis; hemorrhage; hepatocellular carcinoma; radiotherapy