High‑dose hypofractionated X‑ray radiotherapy for hepatocellular carcinoma: Tumor responses and toxicities

Huang,Bing‑Shen; Tsang,Ngan‑Ming; Lin,Shi‑Ming; Lin,Deng‑Yn; Lien,Jau‑Min; Lin,Chen‑Chun; Chen,Wei‑Ting; Chen,Wan‑Yu; Hong,Ji‑Hong

doi:10.3892/ol.2013.1582

High‑dose hypofractionated X‑ray radiotherapy for hepatocellular carcinoma: Tumor responses and toxicities

Authors:
- Bing‑Shen Huang
- Ngan‑Ming Tsang
- Shi‑Ming Lin
- Deng‑Yn Lin
- Jau‑Min Lien
- Chen‑Chun Lin
- Wei‑Ting Chen
- Wan‑Yu Chen
- Ji‑Hong Hong
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Affiliations: Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
Published online on: September 12, 2013 https://doi.org/10.3892/ol.2013.1582
Pages: 1514-1520

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Abstract

Hypofractionated radiotherapy (RT) has been employed to treat hepatocellular carcinoma (HCC). The present study aimed to report the treatment effects, the dose‑response associations and the factors that are associated with radiation‑induced liver disease (RILD) in a high‑dose hypofractionated RT procedure. A total of 40 patients with non‑metastatic HCC who underwent RT for local control of irradiated tumors were studied. The treatment technique was that of three‑dimensional conformal or intensity‑modulated radiation therapy, with a fraction size of 3 Gy and a total dose of 40‑66 Gy in 14‑23 fractions. The biologically‑effective dose (BED) was 52.0‑85.8 Gy10 (median, 74.1 Gy10). Tumor regression was observed in 28 patients (70.0%) with a complete response, partial response, stable disease and progressive disease status in 11 (27.5%), 17 (42.5%), five (12.5%) and seven patients (17.5%), respectively. The one‑, two‑ and five‑year overall survival (OS) and in‑field control (IFC) rates were 60, 40 and 21% and 73, 62 and 56%, respectively. A positive correlation also emerged between the radiation dose and the IFC (P=0.035). Eight of the 40 patients (20%) developed non‑classic RILD. A higher Cancer of the Liver Italian Program score was associated with a higher probability of non‑classic RILD (P=0.02). The tumor response and IFC rate of HCC following irradiation were significantly dose‑dependent. High‑dose hypofractionated X‑ray RT is a feasible and effective treatment for HCC in patients with good liver function and for those who meet the criteria for a curative attempt.

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