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BMC Cancer, Published: 3 September 2010 | https://doi.org/10.1186/1471-2407-10-475 Long-term effect of stereotactic body radiation therapy for primary hepatocellular carcinoma ineligible for local ablation therapy or surgical resection. Stereotactic radiotherapy for liver cancer

Jung Hyun Kwon^1†, Si Hyun Bae^1*†, Ji Yoon Kim^2†, Byung Ock Choi^2†, Hong Seok Jang^2†, Jeong Won Jang^1†, Jong Young Choi^1†, Seung Kew Yoon^1†, Kyu Won Chung^1†¹Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ²Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
^†Contributed equally

^* Correspondence:Si Hyun Bae

Abstract

Background

We evaluated the long-term effect of stereotactic body radiation therapy (SBRT) for primary small hepatocellular carcinoma (HCC) ineligible for local therapy or surgery.

Methods

Forty-two HCC patients with tumors ≤ 100 cc and ineligible for local ablation therapy or surgical resection were treated with SBRT: 30-39 Gy with a prescription isodose range of 70-85% (median 80%) was delivered daily in three fractions. Median tumor volume was 15.4 cc (3.0-81.8) and median follow-up duration 28.7 months (8.4-49.1).

Results

Complete response (CR) for the in-field lesion was initially achieved in 59.6% and partial response (PR) in 26.2% of patients. Hepatic out-of-field progression occurred in 18 patients (42.9%) and distant metastasis developed in 12 (28.6%) patients. Overall in-field CR and overall CR were achieved in 59.6% and 33.3%, respectively. Overall 1-year and 3-year survival rates were 92.9% and 58.6%, respectively. In-field progression-free survival at 1 and 3 years was 72.0% and 67.5%, respectively. Patients with smaller tumor had better in-field progression-free survival and overall survival rates (<32 cc vs. ≥32 cc, P < 0.05). No major toxicity was encountered but one patient died with extrahepatic metastasis and radiation-induced hepatic failure.

Conclusions

SBRT is a promising noninvasive-treatment for small HCC that is ineligible for local treatment or surgical resection.

Keywords : Tace, Stereotactic Body Radiation Therapy, Local Control Rate, Portal Vein Tumor, Thrombosis, Local Ablation Therapy

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