Definitive Stereotactic Body Radiation Therapy in Early-Stage Solitary Hepatocellular Carcinoma: An Australian Multi-Institutional Review of Outcomes
- Author(s)
- Liu, HYH; Lee, YYD; Sridharan, S; Wang, W; Khor, R; Chu, J; Oar, A; Choong, ES; Le, H; Shanker, M; Wigg, A; Stuart, K; Pryor, D;
- Details
- Publication Year 2023-12,Volume 35,Issue #12,Page 787-793
- Journal Title
- Clinical Oncology
- Publication Type
- Research article
- Abstract
- AIMS: Standard curative options for early-stage, solitary hepatocellular carcinoma (HCC) are often unsuitable due to liver dysfunction, comorbidities and/or tumour location. Stereotactic body radiation therapy (SBRT) has shown high rates of local control in HCC; however, limited data exist in the treatment-naïve, curative-intent setting. We report the outcomes of patients with solitary early-stage HCC treated with SBRT as first-line curative-intent therapy. MATERIALS AND METHODS: A multi-institutional retrospective study of treatment-naïve patients with Barcelona Clinic Liver Cancer stage 0/A, solitary ≤5 cm HCC, Child-Pugh score (CPS) A liver function who underwent SBRT between 2010 and 2019 as definitive therapy. The primary end point was freedom from local progression. Secondary end points were progression-free survival, overall survival, rate of treatment-related clinical toxicities and change in CPS >1. RESULTS: In total, 68 patients were evaluated, with a median follow-up of 20 months (range 3-58). The median age was 68 years (range 50-86); 54 (79%) were men, 62 (91%) had cirrhosis and 50 (74%) were Eastern Cooperative Oncology Group 0. The median HCC diameter was 2.5 cm (range 1.3-5) and the median prescription biologically effective dose with a tumour a/b ratio of 10 Gy (BED10) was 93 Gy (interquartile range 72-100 Gy). Two-year freedom from local progression, progression-free survival and overall survival were 94.3% (95% confidence interval 86.6-100%), 59.5% (95% confidence interval 46.3-76.4%) and 88% (95% confidence interval 79.2-97.6%), respectively. Nine patients (13.2%) experienced grade ≥2 treatment-related clinical toxicities. A rise >1 in CPS was observed in six cirrhotic patients (9.6%). CONCLUSION: SBRT is an effective and well-tolerated option to consider in patients with solitary, early-stage HCC. Prospective, randomised comparative studies are warranted to further refine its role as a first-line curative-intent therapy.
- Keywords
- Male; Humans; Middle Aged; Aged; Aged, 80 and over; Female; *Carcinoma, Hepatocellular/surgery; *Liver Neoplasms/surgery; Retrospective Studies; Prospective Studies; *Radiosurgery/adverse effects; Treatment Outcome; Australia/epidemiology; Curative intent; Hepatocellular carcinoma; Stereotactic ablative radiation therapy; Stereotactic body radiation therapy
- Department(s)
- Radiation Oncology
- Publisher's Version
- https://doi.org/10.1016/j.clon.2023.08.012
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-01-19 03:10:19
Last Modified: 2024-07-09 05:52:51