Is local radiotherapy still valuable for patients with multiple intrahepatic hepatocellular carcinomas?

Koom, Woong Sub; Seong, Jinsil; Han, Kwang Hyub; Lee, Do Yun; Lee, Jong Tae
International journal of radiation oncology, biology, physics
2010Aug ; 77 ( 5 ) :1433-40.
저자 상세정보
Koom, Woong Sub -
Seong, Jinsil -
Han, Kwang Hyub -
Lee, Do Yun -
Lee, Jong Tae -
PURPOSE: To investigate whether local radiotherapy (RT) is valuable for patients with multiple hepatocellular carcinomas (HCCs). METHODS AND MATERIALS: From July 1992 to August 2006, 107 patients with unresectable HCC were treated with local RT after incomplete transcatheter arterial chemoembolization (TACE). The RT field included a main tumor with or without other tumor nodules, depending on the effectiveness of TACE. The median RT dose was 50.4 Gy in conventional fractionation. Patients were categorized into four groups: Group 1, single tumor (39 patients); Group 2, multiple tumors within the RT field (25 patients); Group 3, controlled tumors out of the RT field (19 patients); and Group 4, tumors that remained viable out of the RT field (24 patients).

RESULTS: Group 1 showed the best survival rate (MST, 35 months; 2-year OS, 60%) and Group 4 the worst (MST, 5 months; 2-year OS, 16%). Group 2 and Group 3 showed similar survival (MST, 13 vs. 19 months; 2-year OS, 35% vs. 46%; p = 0.698). Significantly worse intrahepatic control in Group 4 was observed. The survival in Groups 2 and 3 (MST, 16 months) was significantly different from that in Group 4 (p = 0.004), and was marginally significant compared with that in Group 1 (p = 0.051).

CONCLUSIONS: Local RT to the main tumor could be applicable in well-controlled intrahepatic tumors out of the RT field. Patients with viable intrahepatic tumors out of the RT field showed worse survival. In future clinical trials, these patients need to be excluded. CI - Copyright 2010 Elsevier Inc. All rights reserved.
Adult, Aged, Analysis of Variance, Carcinoma, Hepatocellular/drug, Chemoembolization, Therapeutic/methods, Combined Modality Therapy/methods, Female, Humans, Infusions, Intra-Arterial/methods, Liver Neoplasms/drug therapy/mortality/pathology/*radiotherapy, Male, Middle Aged, Neoplasms, Multiple Primary/drug therapy/*mortality/pathology/*radiotherapy, Radiotherapy Dosage, Remission Induction, Survival Rate, Tumor Burden

주제명(Target field)
연구참여(Sample size)
질병특성(Condition Category)
연구설계(Study Design)
중재방법(Intervention Type)
중재명칭(Intervention Name)
Application of local RT after unsatisfactory TACE could be considered an option for treatment of multiple intrahepatic tumors, particularly in patients with multiple tumors that are covered by the same RT field.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
ICD 03