Treatment outcome of hepatic re-irradiation in patients with hepatocellular carcinoma

Seol, Seung Won; Yu, Jeong Il; Park, Hee Chul; Lim, Do Hoon; Oh, Dongryul; Noh, Jae Myoung; Cho, Won Kyung; Paik, Seung Woon

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자료유형: 학술저널

저자정보: Seol, Seung Won (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) Yu, Jeong Il (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) Park, Hee Chul (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) Lim, Do Hoon (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) Oh, Dongryul (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) Noh, Jae Myoung (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) Cho, Won Kyung (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) Paik, Seung Woon (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)

저널정보: 대한방사선종양학회 Radiation oncology journal : ROJ Radiation oncology journal : ROJ 제33권 제4호

발행연도: 2015.1

수록면: 276 - 283 (8page)

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Purpose: We evaluated the efficacy and toxicity of repeated high dose 3-dimensional conformal radiation therapy (3D-CRT) for patients with unresectable hepatocellular carcinoma. Materials and Methods: Between 1998 and 2011, 45 patients received hepatic re-irradiation with high dose 3D-CRT in Samsung Medical Center. After excluding two ineligible patients, 43 patients were retrospectively reviewed. RT was delivered with palliative or salvage intent, and equivalent dose of 2 Gy fractions for ${\alpha}/{\beta}=10Gy$ ranged from $31.25Gy_{10}$ to $93.75Gy_{10}$ (median, $44Gy_{10}$). Tumor response and toxicity were evaluated based on the modified Response Evaluation Criteria in Solid Tumors criteria and the Common Terminology Criteria for Adverse Events (CTCAE) ver. 4.0. Results: The median follow-up duration was 11.2 months (range, 4.1 to 58.3 months). An objective tumor response rate was 62.8%. The tumor response rates were 81.0% and 45.5% in patients receiving ${\geq}45Gy_{10}$ and $<45Gy_{10}$, respectively (p = 0.016). The median overall survival (OS) of all patients was 11.2 months. The OS was significantly affected by the Child-Pugh class as 14.2 months vs. 6.1 months (Child-Pugh A vs. B, p < 0.001), and modified Union for International Cancer Control (UICC) T stage as 15.6 months vs. 8.3 months (T1-3 vs. T4, p = 0.004), respectively. Grade III toxicities were developed in two patients, both of whom received ${\geq}50Gy_{10}$. Conclusion: Hepatic re-irradiation may be an effective and tolerable treatment for patients who are not eligible for further local treatment modalities, especially in patients with Child-Pugh A and T1-3.

#Hepatocellular carcinoma #Radiotherapy #Toxicity #Re-irradiation

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