Treatment Outcomes of Hepatocellular Carcinoma Patients who underwent Stereotactic Body Radiotherapy

Abstract

Objective: To evaluate the prognosis of patients with hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT). Material and Methods: A retrospective review was performed of the institutional medical records of patients treated with SBRT. The selection criteria were as follows: unresectable HCC confirmed via pathologically, or through imaging, a Karnofsky Performance Status score >60, any Barcelona Clinic Liver Cancer stage, a Child-Pugh score ≤8, and an uninvolved liver volume >700 cm3 . The primary outcomes were local tumor control, overall survival, and progressionfree survival rates. The secondary outcomes were acute adverse events; including general, gastrointestinal, or hepatic disorders; decreased complete blood count; and increased liver function test results. Results: We included 27 HCC patients treated with SBRT; from August 2013 to October 2019. Moreover, 55.6% of patients had received previous treatments for their SBRT-treated lesions. Additionally, the median volume of internal target volume was 40 cm3 , the median uninvolved liver volume was 1,162 cm3 , and the median radiation dose was 40 Gray: given in five fractions. The 1- and 2-year local tumor control rates were both 79.5%. The 1- and 2-year overall survival rates were 58.8% and 27.6%, respectively, and the median survival was 13 months. There were no grade 4 or 5 acute adverse events observed at initiation of treatment or during the follow-up period. Thirteen percent of patients experienced grade 3 acute adverse events. Three patients experienced radiation-induced liver disease. Conclusion: SBRT can be an effective local treatment for hepatocellular carcinoma in carefully selected patients.

Keywords

• adverse events
• hepatocellular carcinoma
• radiotherapy
• stereotactic body radiotherapy
• treatment outcome