A multicenter retrospective cohort study of practice patterns and clinical outcome on radiotherapy for hepatocellular carcinoma in Korea

Jinsil Seong, Ik Jae Lee, Su Jung Shim, Do Hoon Lim, Tae Hyun Kim, Jong Hoon Kim, Hong Seok Jang, Mi Sook Kim, Eui Kyu Chie, Jin Hee Kim, Taek Keun Nam, Hyung Sik Lee, Chul Joo Han

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Abstract

Aim: To determine the national practice processes of care and outcomes of radiotherapy for hepatocellular carcinoma (HCC) in Korea. Patients and Methods: A national survey of 53 institutions nationwide was conducted by requesting data on their experience of radiotherapy for HCC. Among them, 10 institutions were selected for performing more detailed analysis, based on the radiotherapy experience of at least five HCC patients between 2004 and 2005. Results: This study covered the treatment of 398 HCC patients for 2 years. Most patients (78%) were in stage III or IV. Radiotherapy was chosen after the failure of other treatments, most frequently transarterial chemoembolization. Radiotherapy was performed predominantly using the three-dimensional conformal technique (3D-CRT, 81.9%) mostly with a total dose of ≥45Gy. In 9.3% of the patients, radiotherapy was performed using radiosurgery. In a biologically effective dose (BED) with 10Gy of α/β, 4.2-124.3Gy 10 was delivered. The median survival time was 12 months, and the 2-year overall survival rate was 27.9%. A tumour size <5 cm, a negative lymph node and BED >53.1Gy 10 were shown by multivariate analysis to be significant factors for a better prognosis. In a subset analysis for the 326 patients treated with 3D-CRT, better liver function with Child-Pugh class A was shown to be an additional factor for a better prognosis. Conclusions: Radiotherapy has been used to treat advanced HCC in various modes, but mostly as a salvage treatment. Although this study was retrospective, it indicates that radiotherapy is a quite effective modality for HCC patients.

Original languageEnglish
Pages (from-to)147-152
Number of pages6
JournalLiver International
Volume29
Issue number2
DOIs
Publication statusPublished - 2009

All Science Journal Classification (ASJC) codes

  • Hepatology

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    Seong, J., Lee, I. J., Shim, S. J., Lim, D. H., Kim, T. H., Kim, J. H., Jang, H. S., Kim, M. S., Chie, E. K., Kim, J. H., Nam, T. K., Lee, H. S., & Han, C. J. (2009). A multicenter retrospective cohort study of practice patterns and clinical outcome on radiotherapy for hepatocellular carcinoma in Korea. Liver International, 29(2), 147-152. https://doi.org/10.1111/j.1478-3231.2008.01873.x