TY - JOUR
T1 - SBRT for hepatocellular carcinoma
T2 - 8-Year experience from a regional transplant center
AU - Qiu, Haoming
AU - Moravan, Michael J.
AU - Milano, Michael T.
AU - Usuki, Kenneth Y.
AU - Katz, Alan W.
N1 - Publisher Copyright:
© Springer Science+Business Media, LLC 2017.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Purpose The study aimed to evaluate stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC) in patients not eligible for liver transplant (LT). Methods We retrospectively identified transplant-ineligible HCC patients treated with SBRT to the liver between 2004 and 2013. Our primary endpoint was overall survival (OS). We also report treatment toxicities using CTCAE 3.0, radiographic response, and patterns of failure. Results We identified 93 patients with median age at SBRTof 65.8 years. Forty-six percent were classified as Child-Pugh B or C and 85% had an Eastern Cooperative Oncology Group performance status of 1-2. After SBRT, 86% of patients experienced no or mild treatment-related adverse events. Only 8% of patients experienced grade 3 and 2% of patients experienced grade 4 adverse events. Overall radiographic response was complete in 1.2%, partial in 35.4%, stable in 43.9%, and progressive disease in 19.5%. Median OS was 8.8 months with 1-, 2-, and 3-year OS rates of 38.0, 29.8 and 21.2%, respectively. The Cancer of the Liver Italian Program (CLIP) score was found to strongly correlate with survival. Median OS for patients with CLIP scores of 0, 1, 2, and 3 was 21.1, 8.5, 5.1, and 7.1 months, respectively (p = 0.003). Conclusion Our series demonstrates that SBRT is generally safe for HCC patients, even those with advanced liver failure. Although survival is generally poor, we were able to identify a group of patients with good liver function and early tumor stage who can achieve median OS of close to 2 years with SBRT.
AB - Purpose The study aimed to evaluate stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC) in patients not eligible for liver transplant (LT). Methods We retrospectively identified transplant-ineligible HCC patients treated with SBRT to the liver between 2004 and 2013. Our primary endpoint was overall survival (OS). We also report treatment toxicities using CTCAE 3.0, radiographic response, and patterns of failure. Results We identified 93 patients with median age at SBRTof 65.8 years. Forty-six percent were classified as Child-Pugh B or C and 85% had an Eastern Cooperative Oncology Group performance status of 1-2. After SBRT, 86% of patients experienced no or mild treatment-related adverse events. Only 8% of patients experienced grade 3 and 2% of patients experienced grade 4 adverse events. Overall radiographic response was complete in 1.2%, partial in 35.4%, stable in 43.9%, and progressive disease in 19.5%. Median OS was 8.8 months with 1-, 2-, and 3-year OS rates of 38.0, 29.8 and 21.2%, respectively. The Cancer of the Liver Italian Program (CLIP) score was found to strongly correlate with survival. Median OS for patients with CLIP scores of 0, 1, 2, and 3 was 21.1, 8.5, 5.1, and 7.1 months, respectively (p = 0.003). Conclusion Our series demonstrates that SBRT is generally safe for HCC patients, even those with advanced liver failure. Although survival is generally poor, we were able to identify a group of patients with good liver function and early tumor stage who can achieve median OS of close to 2 years with SBRT.
KW - Child-Pugh B and C
KW - Hepatocellular carcinoma
KW - Non-transplant candidates
KW - SBRT
UR - http://www.scopus.com/inward/record.url?scp=85023773287&partnerID=8YFLogxK
U2 - 10.1007/s12029-017-9990-1
DO - 10.1007/s12029-017-9990-1
M3 - Article
C2 - 28710606
AN - SCOPUS:85023773287
SN - 1941-6628
VL - 49
SP - 463
EP - 469
JO - Journal of Gastrointestinal Cancer
JF - Journal of Gastrointestinal Cancer
IS - 4
ER -