Stereotactic body radiation therapy with or without transarterial chemoembolization for patients with primary hepatocellular carcinoma: preliminary analysis

BMC Cancer. 2008 Nov 27;8:351. doi: 10.1186/1471-2407-8-351.

Abstract

Background: The objectives of this retrospective study was to evaluate the efficacy of stereotactic body radiation therapy (SBRT) for small non-resectable hepatocellular carcinoma (HCC) and SBRT combined with transarterial chemoembolization (TACE) for advanced HCC with portal vein tumor thrombosis (PVTT).

Methods: Thirty one patients with HCC who were treated with SBRT were used for the study. We studied 32 HCC lesions, where 23 lesions (22 patients) were treated targeting small non-resectable primary HCC, and 9 lesions (9 patients) targeting PVTT using the Cyberknife. All the 9 patients targeting PVTT received TACE for the advanced HCC. Tumor volume was 3.6-57.3 cc (median, 25.2 cc) and SBRT dose was 30-39 Gy (median, 36 Gy) in 3 fractions for consecutive days for 70-85% of the planned target volume.

Results: The median follow up was 10.5 months. The overall response rate was 71.9% [small HCC: 82.6% (19/23), advanced HCC with PVTT: 44.4% (4/9)], with the complete and partial response rates of 31.3% [small HCC: 26.1% (6/23), advanced HCC with PVTT: 11.1% (1/9)], and 50.0% [small HCC: 56.5% (13/23), advanced HCC with PVTT: 33.3% (3/9)], respectively. The median survival period of small HCC and advanced HCC with PVTT patients was 12 months and 8 months, respectively. No patient experienced Grade 4 toxicity.

Conclusion: SBRT for small HCC and SBRT combined with TACE for advanced HCC with PVTT showed feasible treatment modalities with minimal side effects in selected patients with primary HCC.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / radiotherapy*
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / adverse effects
  • Chemoembolization, Therapeutic / methods*
  • Combined Modality Therapy
  • Female
  • Humans
  • Liver Neoplasms / surgery*
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Radiosurgery / adverse effects
  • Radiosurgery / methods*
  • Retrospective Studies
  • Treatment Outcome