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Is local radiotherapy still valuable for patients with multiple intrahepatic hepatocellular carcinomas?

Authors
 Woong Sub Koom  ;  Jinsil Seong  ;  Kwang Hyub Han  ;  Do Yun Lee  ;  Jong Tae Lee 
Citation
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.77(5) : 1433-1440, 2010 
Journal Title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
ISSN
 0360-3016 
Issue Date
2010
MeSH
Adult ; Aged ; Analysis of Variance ; Carcinoma, Hepatocellular/drug therapy ; Carcinoma, Hepatocellular/mortality* ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/radiotherapy* ; Carcinoma, Hepatocellular/secondary ; Chemoembolization, Therapeutic/methods ; Combined Modality Therapy/methods ; Female ; Humans ; Infusions, Intra-Arterial/methods ; Liver Neoplasms/drug therapy ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/radiotherapy* ; Male ; Middle Aged ; Neoplasms, Multiple Primary/drug therapy ; Neoplasms, Multiple Primary/mortality* ; Neoplasms, Multiple Primary/pathology ; Neoplasms, Multiple Primary/radiotherapy* ; Radiotherapy Dosage ; Remission Induction ; Survival Rate ; Tumor Burden
Abstract
PURPOSE: To investigate whether local radiotherapy (RT) is valuable for patients with multiple hepatocellular carcinomas (HCCs).

METHODS AND MATERIALS: From July 1992 to August 2006, 107 patients with unresectable HCC were treated with local RT after incomplete transcatheter arterial chemoembolization (TACE). The RT field included a main tumor with or without other tumor nodules, depending on the effectiveness of TACE. The median RT dose was 50.4 Gy in conventional fractionation. Patients were categorized into four groups: Group 1, single tumor (39 patients); Group 2, multiple tumors within the RT field (25 patients); Group 3, controlled tumors out of the RT field (19 patients); and Group 4, tumors that remained viable out of the RT field (24 patients).

RESULTS: Group 1 showed the best survival rate (MST, 35 months; 2-year OS, 60%) and Group 4 the worst (MST, 5 months; 2-year OS, 16%). Group 2 and Group 3 showed similar survival (MST, 13 vs. 19 months; 2-year OS, 35% vs. 46%; p = 0.698). Significantly worse intrahepatic control in Group 4 was observed. The survival in Groups 2 and 3 (MST, 16 months) was significantly different from that in Group 4 (p = 0.004), and was marginally significant compared with that in Group 1 (p = 0.051).

CONCLUSIONS: Local RT to the main tumor could be applicable in well-controlled intrahepatic tumors out of the RT field. Patients with viable intrahepatic tumors out of the RT field showed worse survival. In future clinical trials, these patients need to be excluded.
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301609027199
DOI
10.1016/j.ijrobp.2009.07.1676
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Doo Yun(이두연)
Lee, Jong Tae(이종태)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/102893
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