Feasibility and Efficacy of Stereotactic Ablative Radiotherapy for Barcelona Clinic Liver Cancer-C Stage Hepatocellular Carcinoma

• Published in: Journal of Korean medical science Vol. 28; no. 2; pp. 213 - 219
• Main Authors: Bae, Sun Hyun, Kim, Mi-Sook, Cho, Chul Koo, Kim, Kum Bae, Lee, Dong Han, Han, Chul Ju, Park, Su Cheol, Kim, Young Han
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.02.2013; 대한의학회
• Subjects: Adult; Aged; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - radiotherapy; Feasibility Studies; Female; Follow-Up Studies; Humans; Liver Failure - etiology; Liver Neoplasms - mortality; Liver Neoplasms - radiotherapy; Male; Middle Aged; Myelitis - etiology; Neoplasm Staging; Original; Prognosis; Radiation Dosage; Retrospective Studies; Severity of Illness Index; Stereotaxic Techniques; Survival Rate; 의학일반; Hepatocellular; Carcinoma; Neoplasm Staging; Radiotherapy; Stereotactic Techniques
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2013.28.2.213

The purpose of this study was to assess the feasibility and efficacy of stereotactic ablative radiotherapy (SABR) for liver tumor in patients with Barcelona Clinic Liver Cancer (BCLC)-C stage hepatocellular carcinoma (HCC). We retrospectively reviewed the medical records of 35 patients between 2003 and 2011. Vascular invasion was diagnosed in 32 patients, extrahepatic metastases in 11 and both in 8. Thirty-two patients were categorized under Child-Pugh (CP) class A and 3 patients with CP class B. The median SABR dose was 45 Gy (range, 30-60 Gy) in 3-5 fractions. The median survival time was 14 months. The 1- and 3-yr overall survival (OS) rate was 52% and 21%, respectively. On univariate analysis, CP class A and biologically equivalent dose ≥ 80 Gy(10) were significant determinants of better OS. Severe toxicity above grade 3, requiring prompt therapeutic intervention, was observed in 5 patients. In conclusion, SABR for BCLC-C stage HCC showed 1-yr OS rate of 52% but treatment related toxicity was moderate. We suggest that patients with CP class A are the best candidate and at least SABR dose of 80 Gy(10) is required for BCLC-C stage.