The efficacy of stereotactic body radiation therapy on huge hepatocellular carcinoma unsuitable for other local modalities

Radiation Oncology

Ching-Chieh Yang¹  Yu-Wei Lin¹  Chia-Hui Lin¹  Kuei-Li Lin¹  Li-Ching Lin¹  Jenny Y Que¹ 

[1] Department of Radiation Oncology, Chi Mei Medical Center, No.901, Zhonghua Road, Yongkang district, Tainan, Taiwan

关键词: Stereotactic body radiation therapy;    Hepatocellular carcinoma;    Huge;   

Others  :  802764
DOI  :  10.1186/1748-717X-9-120

 received in 2013-09-06, accepted in 2014-05-07,  发布年份 2014

【 摘 要 】

Background and aim

To evaluate the safety and efficacy of Cyberknife stereotactic body radiation therapy (SBRT) and its effect on survival in patients with unresectable huge hepatocellular carcinoma (HCC) unsuitable of other standard treatment option.

Methods

Between 2009 and 2011, 22 patients with unresectable huge HCC (≧10 cm) were treated with SBRT. dose ranged from 26 Gy to 40 Gy in five fractions. Overall survival (OS) and disease-progression free survival (DPFS) were determined by Kaplan-Meier analysis. Tumor response and toxicities were also assessed.

Results

After a median follow-up of 11.5 month (range 2–46 months). The objective response rate was achieved in 86.3% (complete response (CR): 22.7% and partial response (PR): 63.6%). The 1-yr. local control rate was 55.56%. The 1-year OS was 50% and median survival was 11 months (range 2–46 months). In univariate analysis, Child-Pugh stage (p = 0.0056) and SBRT dose (p = 0.0017) were significant factors for survival. However, in multivariate analysis, SBRT dose (p = 0.0072) was the most significant factor, while Child-Pugh stage of borderline significance. (p = 0.0514). Acute toxicities were mild and well tolerated.

Conclusion

This study showed that SBRT can be delivered safely to huge HCC and achieved a substantial tumor regression and survival. The results suggest this technique should be considered a salvage treatment. However, local and regional recurrence remain the major cause of failure. Further studies of combination of SBRT and other treatment modalities may be reasonable.

【 授权许可】

   
2014 Que et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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