title: Survival outcomes after stereotactic body radiotherapy for 79 Japanese patients with hepatocellular carcinoma.
abstract: Stereotactic body radiotherapy (SBRT) is a relatively new treatment for liver tumor. Outcomes of SBRT for liver tumors unsuitable for ablation or surgical resection were evaluated. A total of 79 patients treated with SBRT for primary hepatocellular carcinoma (HCC) between 2004 and 2012 in six Japanese institutions were studied retrospectively. Patients treated with SBRT preceded by trans-arterial chemoembolization were eligible. Their median age was 73 years, 76% were males, and their Child-Pugh scores were Grades A (85%) and B (11%) before SBRT. The median biologically effective dose (α/β = 10 Gy) was 96.3 Gy. The median follow-up time was 21.0 months for surviving patients. The 2-year overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival were 53%, 40% and 76%, respectively. Sex and serum PIVKA-II values were significant predictive factors for OS. Hypovascular or hypervascular types of HCC, sex and clinical stage were significant predictive factors for PFS. The 2-year PFS was 66% in Stage I vs 18% in Stages II-III. Multivariate analysis indicated that clinical stage was the only significant predictive factor for PFS. No Grade 3 laboratory toxicities in the acute, sub-acute, and chronic phases were observed. PFS after SBRT for liver tumor was satisfactory, especially for Stage I HCC, even though these patients were unsuitable for resection and ablation. SBRT is safe and might be an alternative to resection and ablation.
authors.affiliation: Department of Radiology, University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan yamachan07291973@yahoo.co.jp.
authors.forename: Hideomi
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Radiology, Yamanashi University.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
authors.affiliation: Department of Radiology, National Cancer Center Hospital.
authors.forename: Naoya
authors.initials: N
authors.lastname: Murakami
authors.affiliation: Department of Radiology, Niigata University School of Medicine.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: Department of Radiology, Yamagata University Hospital.
authors.forename: Takuma
authors.initials: T
authors.lastname: Nomiya
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control; D015995:Prevalence; D016634:Radiosurgery / Q000401:mortality* / Q000706:statistics & numerical data; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome
keywords: SBRT; hepatocellular carcinoma; stereotactic body radiotherapy