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Japanese Journal of Clinical Oncology Advance Access published online on December 1, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl128
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© 2006 Foundation for Promotion of Cancer Research

A Retrospective Study of Radiotherapy for Spinal Bone Metastases from Hepatocellular Carcinoma (HCC)

Naoki Nakamura1,, Hiroshi Igaki1, Hideomi Yamashita1, Kenshiro Shiraishi1, Masao Tago1, Nakashi Sasano1, Syuichiro Shiina2, Masao Omata2, Masatoshi Makuuchi3, Kuni Ohtomo1 and Keiichi Nakagawa1

1 Department of Radiology
2 Department of Gastroenterology
3 Department of Hepato-Biliary-Pancreatic Surgery, Tokyo University Hospital, Tokyo, Japan

For reprints and all correspondence: Naoki Nakamura, Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. E-mail: nnakamur-tky{at}umin.ac.jp

Received July 31, 2006; accepted August 21, 2006

OBJECTIVE: To evaluate the therapeutic effects of radiotherapy on spinal bone metastases from hepatocellular carcinoma (HCC).

METHODS: A retrospective review was conducted on 24 ambulatory patients with spinal bone metastases from HCC treated by radiotherapy from 1995 to 2004. Ambulatory rate and local progression-free rate after radiotherapy were analyzed. Eight (33%) of 24 patients had radiographic spinal cord compression from the spinal bone metastases before the treatment. Two (8.3%) of the 24 patients had some spinal deficits before the treatment. Biological equivalent dose (BED) with {alpha}/ß ratios of 10 ranged from 39 to 50.7 Gy (median 44.8 Gy).

RESULTS: The median observation period was 5.1 months ranging from 0.9 to 36.0 months. Among the 24 patients, five (21%) underwent salvage therapies, while of the remaining 19 patients four (21%) became nonambulatory by the last follow-up. The ambulatory rates at 3 months and 6 months were 85 and 63%, respectively. The local progression-free rates at 3 months and 6 months were 53 and 47%, respectively.

CONCLUSIONS: Radiotherapy with a BED of 39–50.7 Gy (median 44.8 Gy) is not sufficiently effective for the patients with spinal bone metastases from HCC to prevent paralysis. Dose escalation with a highly precise radiation technique will need to be evaluated.

Key Words: HCC • spinal bone metastases • radiotherapy • gait function


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