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

Journal of Korean Medical Science 2013년 28권 2호 p.213 ~ p.219

배선현(Bae Sun-Hyun) - Korea Institute of Radiological and Medical Sciences Department of Radiation Oncology
김미숙(Kim Mi-Sook) - Korea Institute of Radiological and Medical Sciences Department of Radiation Oncology
조철구(Cho Chul-Koo) - Korea Institute of Radiological & Medical Sciences Department of Radiation Oncology
김금배(Kim Kum-Bae) - Korea Institute of Radiological & Medical Sciences Department of Radiation Oncology
이동한(Lee Dong-Han) - Korea Institute of Radiological and Medical Sciences CyberKnife Center
한철주(Han Chul-Ju) - Korea Institute of Radiological & Medical Sciences Department of Internal Medicine
박수철(Park Su-Cheol) - Korea Institute of Radiological and Medical Sciences Korea Cancer Center Hospital Department of Internal Medicine
김영한(Kim Young-Han) - Korea Institute of Radiological & Medical Sciences Korea Cancer Center Hospital Department of Radiology

Abstract

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 Gy10 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 Gy10 is required for BCLC-C stage.