Conformal radiotherapy as a bridge to liver transplantation for hepatocellular carcinoma: is it safe?
OBJECTIVE
To report a preliminary experience of conformal radiotherapy (CRT) as bridge to orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).


METHODS
Data of 12 patients undergoing CRT for HCC followed by OLT between 2012 and 2014 were reviewed.


RESULTS
CRT was used in a neoadjuvant or downstaging setting in nine and three patients, respectively. No radiation-related systemic toxicity was observed. Median blood loss and operating time were 1450 ml (600-4000) and 420 min (240-510), respectively. Four patients had diaphragmatic injury. Complete histological response was observed in six patients, and partial response in five. Seven patients developed severe postoperative morbidity including five anastomosis-related complications and one death.


CONCLUSIONS
CRT for HCC provides satisfactory histological response but may compromise OLT safety.
Department of General Surgery & Liver Transplant, Hospices Civils de Lyon, Croix-Rousse University Hospital, Lyon, France.|Equipe Mixte de Recherche 3738, Ecole Doctorale EDISS 205, Université Claude Bernard Lyon 1, Lyon, France.
Kayvan
K
Mohkam
Department of General Surgery & Liver Transplant, Hospices Civils de Lyon, Croix-Rousse University Hospital, Lyon, France.
Nicolas
N
Golse
Department of General Surgery & Liver Transplant, Hospices Civils de Lyon, Croix-Rousse University Hospital, Lyon, France.
Mathieu
M
Bonal
Intensive Care Unit, Hospices Civils de Lyon, Lyon-Sud University Hospital, Pierre-Bénite, France.
Stanislas
S
Ledochowski
Department of Radiology, Hospices Civils de Lyon, Croix-Rousse University Hospital, Lyon, France.
Agnès
A
Rode
Department of Radiation Oncology, Hospices Civils de Lyon, Lyon-Sud University Hospital, Pierre-Bénite, France.
Imad E
IE
Selmaji
Department of Hepatology, Hospices Civils de Lyon, Croix-Rousse University Hospital, Lyon, France.
Philippe
P
Merle
Department of General Surgery & Liver Transplant, Hospices Civils de Lyon, Croix-Rousse University Hospital, Lyon, France.
Christian
C
Ducerf
Equipe Mixte de Recherche 3738, Ecole Doctorale EDISS 205, Université Claude Bernard Lyon 1, Lyon, France.|Department of Radiation Oncology, Hospices Civils de Lyon, Lyon-Sud University Hospital, Pierre-Bénite, France.
Françoise
F
Mornex
Department of General Surgery & Liver Transplant, Hospices Civils de Lyon, Croix-Rousse University Hospital, Lyon, France.|Equipe Mixte de Recherche 3738, Ecole Doctorale EDISS 205, Université Claude Bernard Lyon 1, Lyon, France.
Jean-Yves
JY
Mabrut
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy* / Q000601:surgery; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
bridging therapy; conformal radiotherapy; hepatocellular carcinoma; morbidity; orthotopic liver transplantation