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J Korean Soc Ther Radiol Oncol > Volume 23(2); 2005 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2005;23(2): 92-97.
Effects of Fractionated Stereotactic Radiotherapy for Primary Hepatocellular Carcinoma
Byeong Ock Choi, Ki Mun Kang, Hong Seok Jang, Sang Wook Lee, Young Nam Kang, Gyu Young Chai, Ihl Bhong Choi
1Department of Radiation Oncology, The Catholic University of Korea College of Medicine, Seoul, Korea.
2Department of Radiation Oncology, Gyeongsang National University College of Medicine, Korea. jsk92@nongae.gsnu.ac.kr
3Gyeongsang Institute of Health Sciences, Jinju, Korea.
4Department of Radiation Oncology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Reports on the outcome of curative radiotherapy for the primary hepatocellular carcinoma (HCC) are rarely encountered in the literature. In this study, we report our experience of a clinical trial where fractionated stereotactic radiotherapy (SRT) was used in treating a primary HCC.
A retrospective analysis was performed on 20 patients who had been histologically diagnosed as HCC and treated by fractionated SRT. The long diameter of tumor measured by CT was 2~6.5 cm (average: 3.8 cm). A single dose of radiation used in fractionated SRT was 5 or 10 Gy; each dose was prescribed based on the planning target volume and normalized to 85~99% isocenter dose. Patients were treated 3~5 times per week for 2 weeks, with each receiving a total dose of 50 Gy (the median dose: 50 Gy). The follow up period was 3~55 months (the median follow up period: 23 months).
The response rate was 60% (12 patients), with 4 patients showing complete response (20%), 8 patients showing partial response (40%), and 8 patients showing stable disease (40%). The 1-year and 2-year survival rates were 70.0% and 43.1%, respectively, and the median survival time was 20 months. The 1-year and 2-year disease free survival rates were 65% and 32.5%, respectively, and the median disease-free survival rate was 19 months. Some acute complications of the treatment were noted as follows: dyspepsia in 12 patients (60%), nausea/emesis in 8 patients (40%), and transient liver function impairment in 6 patients (30%). However, there was no treatment related death.
The study indicates that fractionated SRT is a relatively safe and effective method for treating primary HCC. Thus, fractionated SRT may be suggested as a local treatment for HCC of small lesion and containing a single lesion, when the patients are inoperable or operation is refused by the patients. We thought that fractionated SRT is a challenging treatment modality for the HCC.
Key Words: Hepatocellular carcinoma, Fractionated stereotactic radiotherapy
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