Research article

Stereotactic body radiation therapy with or without transarterial chemoembolization for patients with primary hepatocellular carcinoma: preliminary analysis

Byung Ock Choi¹ , Ihl Bohng Choi^{* 1} , Hong Seok Jang¹ , Young Nam Kang¹ , Ji Sun Jang¹ , Si Hyun Bae² , Seung Kew Yoon² , Gyu Young Chai³ and Ki Mun Kang^{* 3}

¹Department of Radiation Oncology, The Catholic University of Korea, School of Medicine, Seoul, South Korea

²Department of Internal Medicine, The Catholic University of Korea, School of Medicine, WHO Collaborating College of Medicine, Seoul, South Korea

³Department of Radiation Oncology, Gyeongsang National University, College of Medicine, Gyeongsang Institute of Health Sciences, Jinju, South Korea

author email corresponding author email* Contributed equally

BMC Cancer 2008, 8:351doi:10.1186/1471-2407-8-351

Published:	27 November 2008

Abstract

Background

The objectives of this retrospective study was to evaluate the efficacy of stereotactic body radiation therapy (SBRT) for small non-resectable hepatocellular carcinoma (HCC) and SBRT combined with transarterial chemoembolization (TACE) for advanced HCC with portal vein tumor thrombosis (PVTT).

Methods

Thirty one patients with HCC who were treated with SBRT were used for the study. We studied 32 HCC lesions, where 23 lesions (22 patients) were treated targeting small non-resectable primary HCC, and 9 lesions (9 patients) targeting PVTT using the Cyberknife. All the 9 patients targeting PVTT received TACE for the advanced HCC. Tumor volume was 3.6–57.3 cc (median, 25.2 cc) and SBRT dose was 30–39 Gy (median, 36 Gy) in 3 fractions for consecutive days for 70–85% of the planned target volume.

Results

The median follow up was 10.5 months. The overall response rate was 71.9% [small HCC: 82.6% (19/23), advanced HCC with PVTT: 44.4% (4/9)], with the complete and partial response rates of 31.3% [small HCC: 26.1% (6/23), advanced HCC with PVTT: 11.1% (1/9)], and 50.0% [small HCC: 56.5% (13/23), advanced HCC with PVTT: 33.3% (3/9)], respectively. The median survival period of small HCC and advanced HCC with PVTT patients was 12 months and 8 months, respectively. No patient experienced Grade 4 toxicity.

Conclusion

SBRT for small HCC and SBRT combined with TACE for advanced HCC with PVTT showed feasible treatment modalities with minimal side effects in selected patients with primary HCC.