Outcomes following definitive stereotactic body radiotherapy for patients with Child-Pugh B or C hepatocellular carcinoma

Radiother Oncol. 2014 Jun;111(3):412-7. doi: 10.1016/j.radonc.2014.05.002. Epub 2014 Jun 3.

Abstract

Purpose: To report outcomes in patients with Child-Pugh B or C (CP B/C) hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT).

Methods and materials: A prospective study of SBRT was developed for patients with CP B7 or B8 unresectable HCC, <10 cm. Selected ineligible patients (e.g. CP>B8, >10 cm) treated off-study from 2004 to July 2012 were also reviewed. Patients were excluded if they were treated as a bridge-to-liver-transplant.

Results: 29 patients with CP B/C HCC were treated with SBRT (median dose 30 Gy in 6 fractions) from 2004 to December 2012. The majority had CP B7 liver function (69%) and portal vein tumor thrombosis (76%). The median survival was 7.9 months (95% CI: 2.8-15.1). Survival was significantly better in patients with CP=B7 and AFP≤4491 ng/mL. Of 16 evaluable patients, 63% had a decline in CP score by ≥2 points at 3 months.

Conclusion: SBRT is a treatment option for selected HCC patients with small HCCs and modestly impaired (CP B7) liver function.

Keywords: Child-Pugh B; Hepatocellular carcinoma; SBRT; Stereotactic body radiotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / physiopathology
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Humans
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / physiopathology*
  • Liver Neoplasms / physiopathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiosurgery / methods*
  • Retrospective Studies
  • Treatment Outcome