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- Title
Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05).
- Authors
Sun Hyun Bae; Hee Chul Park; Won Sup Yoon; Sang Min Yoon; In-Hye Jung; Ik Jae Lee; Jun Won Kim; Jinsil Seong; Tae Hyun Kim; Taek-Keun Nam; Youngmin Choi; Sun Young Lee; Hong Seok Jang; Dong Soo Lee; Jin Hee Kim
- Abstract
Purpose There is limited data on radiotherapy (RT) for hepatocellular carcinoma (HCC) in patients with Child-Pugh classification B (CP-B). This study aimed to evaluate the treatment outcomes of fractionated conformal RT in HCC patients with CP-B. Materials and Methods We retrospectively reviewed the data of HCC patients with CP-B treated with RT between 2009 and 2014 at 13 institutions in Korea. HCC was diagnosed by the Korea guideline of 2009, and modern RT techniques were applied. Fraction size was ≤ 5 Gy and the biologically effective dose (BED) ≥ 40 Gy10 (α/β = 10 Gy). A total of 184 patients were included in this study. Results Initial CP score was seven in 62.0% of patients, eight in 31.0%, and nine in 7.0%. Portal vein tumor thrombosis was present in 66.3% of patients. The BED ranged from 40.4 to 89.6 Gy10 (median, 56.0 Gy10). After RT completion, 48.4% of patients underwent additional treatment. The median overall survival (OS) was 9.4 months. The local progression-free survival and OS rates at 1 year were 58.9% and 39.8%, respectively. In the multivariate analysis, non-classic radiation-induced liver disease (RILD) (p < 0.001) and additional treatment (p < 0.001) were the most significant prognostic factors of OS. Among 132 evaluable patients without progressive disease, 19.7% experienced non-classic RILD. Normal liver volume was the most predictive dosimetric parameter of non-classic RILD. Conclusion Fractionated conformal RT showed favorable OS with a moderate risk non-classic RILD. The individual radiotherapy for CP-B could be cautiously applied weighing the survival benefits and the RILD risks.
- Subjects
SOUTH Korea; TREATMENT effectiveness; PORTAL vein; PROGRESSION-free survival; LIVER diseases; MULTIVARIATE analysis
- Publication
Cancer Research & Treatment, 2019, Vol 51, Issue 4, p1589
- ISSN
1598-2998
- Publication type
Article
- DOI
10.4143/crt.2018.687