Hypofractionated Radiotherapy for Small-sized Hepatocellular Carcinoma as Salvage Therapy: Sustained Local Control and Safety.
10.3857/jkstro.2010.28.2.85
- Author:
Sun Hyun BAE
1
;
Hee Chul PARK
;
Do Hoon LIM
;
Jung Ae LEE
;
Moon Seok CHOI
;
Joon Hyoek LEE
;
Kwang Cheol KOH
;
Seung Woon PAIK
;
Byung Chul YOO
Author Information
1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. rophc@skku.edu
- Publication Type:Original Article
- Keywords:
Hepatocellular carcinoma;
Radiation;
Hypofractionation
- MeSH:
Ascites;
Carcinoma, Hepatocellular;
Follow-Up Studies;
Humans;
Liver;
Nausea;
Neoplasm Metastasis;
Portal Vein;
Salvage Therapy;
Survival Rate;
Thrombosis
- From:The Journal of the Korean Society for Therapeutic Radiology and Oncology
2010;28(2):85-90
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the rate of tumor response, local control, and treatment-related complications after hypofractionated radiotherapy for recurrent hepatocelluar carcinoma (HCC) less than 5 cm in size. MATERIALS AND METHODS: Among the HCC patients who were treated by radiotherapy (RT) between 2006 and 2007 after the failure of previous treatment, a total of 12 patients were treated with hypofractionated RT. The criteria for hypofractionated RT was as follows: 1) HCC less than 5 cm, 2) HCC not adjacent to a critical organ, 3) HCC without portal vein tumor thrombosis, and 4) less than 15% of normal liver volume that irradiated 50% of the prescribed dose. Hypofractionated RT was performed with 50 Gy delivered in 10 fractions, at a rate of 5 fractions per week. The evaluation of tumor response was determined by CT scans performed at 3 months after the cessation of RT, followed by the evaluation of toxicity by Common Terminology Criteria for Adverse Events version 3.0. The median follow-up period after radiotherapy was 18 months. RESULTS: A complete response (CR) was achieved in 5 of 12 lesions (41.7%) at CT performed at 3 months after the cessation, whereas the overall complete response was observed in 7 of 12 cases (58.3%). In-field local control rate was sustained in 83.3% of patients. All patients developed intra-hepatic metastases except for 2 patients. The overall survival rate was 90.0% at 1 year and 67.5% at 2 years, respectively. Three patients developed Grade 1 nausea during RT and 1 patient showed a progression of ascites after RT. There was no grade 3 or greater treatment-related toxicities. CONCLUSION: Hypofractionated RT for small-sized HCC as a salvage therapy showed a 58.3% CR rate and 83.3% of local control. Fifty Gy administered in 10 fractions of partial liver irradiation is considered as a tolerable dose that does not cause severe complications.
