Long-term Results of Palliative Stereotactic Radiotherapy of Barcelona Clinic Liver Cancer Stage C Hepatitis B–Related Hepatocellular Carcinoma

• Published in: Hong Kong journal of radiology : HKJR = Xianggang fang she ke yi xue za zhi Vol. 24; no. 2; pp. 81 - 86
• Main Authors: Choi, CKK, Ho, CHM, Wong, MYP, Leung, RWK, Wong, FCS, Tung, SY, Lee, FAS
• Format: Journal Article
• Language: English
• Published: Hong Kong Hong Kong Academy of Medicine 01-06-2021
• Subjects: Cancer therapies; Hepatitis; Hepatitis B; Liver cancer; Medical prognosis; Multivariate analysis; Pain; Patients; Radiation therapy; Radiosurgery; Response rates; Tumors; Hong Kong China
• ISSN: 2223-6619; 2307-4620
• DOI: 10.12809/hkjr2117253

Objective To assess the long-term effectiveness of palliative stereotactic body radiotherapy (SBRT) in patients with large unresectable Barcelona Clinic Liver Cancer stage C hepatitis B–related hepatocellular carcinomas (HCCs). Methods Consecutive HCC cases treated with fractionated SBRT between January 2008 and December 2010 were analysed. The long-term survival and response rate were evaluated. Univariate and multivariate analyses were performed to identify the significant predictors of survival. Results In total, 32 cases were analysed, with median gross tumour volume was 509.5 cm3 (range, 2.2-3088 cm3). Median treatment prescription was 32 Gy (range, 20-40 Gy) in five to 10 fractions over 1 to 2 weeks. Median followup was 13.4 months; median survival was 13.3 months (95% confidence interval [CI]=11.4-15.2). Stable and partial tumour response rates by RECIST criteria were 69% and 31%, respectively. Alpha-fetoprotein reduction at ≥3 months after radiotherapy (p = 0.018) and gain in body weight after SBRT (p < 0.001) were significantly associated with longer survival after multivariate analysis. Conclusion SBRT with dose individualisation can be delivered safely to large unresectable tumours in patients with HBV-related HCC. The median survival after SBRT in this study was 13.3 months. Alpha-fetoprotein reduction at ≥3 months and weight gain after radiotherapy were positive prognostic factors for longer survival. More prospective studies are warranted to confirm these results.