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Japanese Journal of Clinical Oncology Advance Access published online on March 6, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyi236
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© 2006 Foundation for Promotion of Cancer Research
Received October 19, 2005
Accepted December 17, 2005

Original Article

Fractionated Stereotactic Radiotherapy in Patients with Primary Hepatocellular Carcinoma

Byung Ock Choi 1, Hong Seok Jang 1, Ki Mun Kang 2 *, Sang Wook Lee 3, Young Nam Kang 1, Gyu Young Chai 2, and Ihl Bhong Choi 1

1 Department of Radiation Oncology, The Catholic University of Korea, College of Medicine, Seoul, Korea
2 Department of Radiation Oncology, Gyeongsang National University, College of Medicine, Gyeongsang Institute of Health Sciences, Jinju, Korea
3 Department of Radiation Oncology, University of Ulsan, Asan Medical Center, Seoul, Korea

* To whom correspondence should be addressed.
Ki Mun Kang, E-mail: jsk92{at}nongae.gsnu.ac.kr


  Abstract

Objective: The purpose of our study was to evaluate the feasibility and treatment outcomes of fractionated stereotactic radiotherapy (SRT) for primary hepatocellular carcinoma (HCC).

Methods: We enrolled 20 patients who had been histologically diagnosed as HCC patients and treated by fractionated SRT. Tumor size was 2-6.5 cm (average: 3.8 cm). We prescribed 50 Gy in 5 or 10 fractions at the 85-90% isodose line of the planning target volume for 2 weeks. The follow-up period was 3-55 months (median: 23 months).

Results: The overall response rate was 80%, with 4 patients showing complete response (20%), 14 patients showing partial response (60%) and 4 patients showing stable disease (20%). The 1-year and 2-year survival rates were 70.0 and 43.1%, respectively (median: 20 months). The 1-year and 2-year disease-free survival rates were 65.0 and 32.5%, respectively (median: 19 months). The fractionated SRT was well tolerated, because grade 3 or grade 4 toxicity was not observed.

Conclusion: These results suggest that fractionated SRT is a relatively safe and effective method for treating small primary HCC. Thus, fractionated SRT may be suggested as a local treatment of choice for small HCC when the patients are inoperable or when the patients refuse operation.

Keywords: fractionation; hepatocellular carcinoma; stereotactic radiotherapy.
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