Treatment outcome after fractionated conformal radiotherapy for hepatocellular carcinoma in patients with child-pugh classification B in Korea (KROG 16-05)

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

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4 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1589-1599
Number of pages11
JournalCancer Research and Treatment
Volume51
Issue number4
DOIs
Publication statusPublished - 2019 Oct

Bibliographical note

Funding Information:
This work was supported by the Soonchunhyang University Research Fund.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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