Stereotactic body radiation therapy in recurrent hepatocellular carcinoma

Wen Yen Huang, Yee Min Jen, Meei Shyuan Lee, Li Ping Chang, Chang Ming Chen, Kai Hsiung Ko, Kuen Tze Lin, Jang Chun Lin, Hsing Lung Chao, Chun Shu Lin, Yu Fu Su, Chao Yueh Fan, Yao Wen Chang

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Abstract

Purpose: To examine the safety and efficacy of Cyberknife stereotactic body radiation therapy (SBRT) and its effect on survival in patients of recurrent hepatocellular carcinoma (HCC). Methods and Materials: This was a matched-pair study. From January 2008 to December 2009, 36 patients with 42 lesions of unresectable recurrent HCC were treated with SBRT. The median prescribed dose was 37 Gy (range, 25 to 48 Gy) in 4-5 fractions over 4-5 consecutive working days. Another 138 patients in the historical control group given other or no treatments were selected for matched analyses. Results: The median follow-up time was 14 months for all patients and 20 months for those alive. The 1- and 2-year in-field failure-free rates were 87.6% and 75.1%, respectively. Out-field intrahepatic recurrence was the main cause of failure. The 2-year overall survival (OS) rate was 64.0%, and median time to progression was 8.0 months. In the multivariable analysis of all 174 patients, SBRT (yes vs. no), tumor size (≤4 cm vs. >4 cm), recurrent stage (stage IIIB/IV vs. I) and Child-Pugh classification (A vs. B/C) were independent prognostic factors for OS. Matched-pair analysis revealed that patients undergoing SBRT had better OS (2-year OS of 72.6% vs. 42.1%, respectively, p = 0.013). Acute toxicities were mild and tolerable. Conclusion: SBRT is a safe and efficacious modality and appears to be well-tolerated at the dose fractionation we have used, and its use correlates with improved survival in this cohort of patients with recurrent unresectable HCC. Out-field recurrence is the major cause of failure. Further studies of combinations of SBRT and systemic therapies may be reasonable.

Original languageEnglish
Pages (from-to)355-361
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume84
Issue number2
DOIs
Publication statusPublished - Oct 1 2012
Externally publishedYes

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Keywords

  • Cyberknife
  • Radiotherapy
  • Recurrent hepatocellular carcinoma
  • Stereotactic body radiation therapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Huang, W. Y., Jen, Y. M., Lee, M. S., Chang, L. P., Chen, C. M., Ko, K. H., Lin, K. T., Lin, J. C., Chao, H. L., Lin, C. S., Su, Y. F., Fan, C. Y., & Chang, Y. W. (2012). Stereotactic body radiation therapy in recurrent hepatocellular carcinoma. International Journal of Radiation Oncology Biology Physics, 84(2), 355-361. https://doi.org/10.1016/j.ijrobp.2011.11.058