title: Clinical Practice Patterns of Radiotherapy in Patients with Hepatocellular Carcinoma: A Korean Radiation Oncology Group Study (KROG 14-07).
abstract: OBJECTIVE
  The aim of this study was to examine patterns of radiotherapy (RT) in Korean patients with hepatocellular carcinoma (HCC) according to the evolving guideline for HCC established by the Korean Liver Cancer Study Group-National Cancer Center (KLCSG-NCC).
  
  
  METHODS
  We reviewed 765 patients with HCC who were treated with RT between January 2011 and December 2012 in 12 institutions.
  
  
  RESULTS
  The median follow-up period was 13.3 months (range, 0.2 to 51.7 months). Compared with previous data between 2004 and 2005, the use of RT as a first treatment has increased (9.0% vs. 40.8%). Increased application of intensity-modulated RT resulted in an increase in radiation dose (fractional dose, 1.8 Gy vs. 2.5 Gy; biologically effective dose, 53.1 Gy10vs. 56.3 Gy10). Median overall survival was 16.2 months, which is longer than that reported in previous data (12 months). In subgroup analysis, treatments were significantly different according to stage (p < 0.001). Stereotactic body RT was used in patients with early HCC, and most patients with advanced stage were treated with three-dimensional conformal RT.
  
  
  CONCLUSIONS
  Based on the evolving KLCSG-NCC practice guideline for HCC, clinical practice patterns of RT have changed. Although RT is still used mainly in advanced HCC, the number of patients with good performance status who were treated with RT as a first treatment has increased. This change in practice patterns could result in improvement in overall survival.
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.|Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyejung
authors.initials: H
authors.lastname: Cha
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Korea.
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jeong Il
authors.initials: JI
authors.lastname: Yu
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Taek-Keun
authors.initials: TK
authors.lastname: Nam
authors.affiliation: Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Yoon
authors.affiliation: Department of Radiation Oncology, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Yoon
authors.affiliation: Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jun Won
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
authors.forename: Mi Sook
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Jang
authors.affiliation: Department of Radiation Oncology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Youngmin
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
authors.forename: Chul Seung
authors.initials: CS
authors.lastname: Kay
authors.affiliation: Department of Biostatistics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Inkyung
authors.initials: I
authors.lastname: Jung
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jinsil
authors.initials: J
authors.lastname: Seong
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000532:radiotherapy; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011878:Radiotherapy / Q000379:methods / Q000706:statistics & numerical data; D056910:Republic of Korea / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: Clinical practice pattern; Hepatocellular carcinoma; Radiotherapy