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Therapeutic benefit of radiotherapy in huge (≥10 cm) unresectable hepatocellular carcinoma

Authors
 Kyung Hwan Kim  ;  Mi Sun Kim  ;  Jee Suk Chang  ;  Kwang-Hyub Han  ;  Do Young Kim  ;  Jinsil Seong 
Citation
 LIVER INTERNATIONAL, Vol.34(5) : 784-794, 2014 
Journal Title
 LIVER INTERNATIONAL 
ISSN
 1478-3223 
Issue Date
2014
MeSH
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/radiotherapy* ; Female ; Humans ; Liver/pathology ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/radiotherapy* ; Male ; Middle Aged ; Prognosis ; Radiotherapy/adverse effects ; Republic of Korea/epidemiology ; Retrospective Studies
Keywords
huge hepatocellular carcinoma ; radiotherapy ; survival ; unresectable
Abstract
BACKGROUND & AIMS: Huge (≥10 cm) hepatocellular carcinomas (HCCs) show dismal prognosis and only a limited number of cases are eligible for curative resection. We studied the therapeutic benefit of radiotherapy (RT) in patients with huge unresectable HCCs. METHODS: Data from 283 patients with huge HCCs and preserved liver function who underwent non-surgical treatment from July 2001 to March 2012 were retrospectively reviewed. Patients were divided into 4 groups according to the initial treatment: Group A (N= 49), transarterial chemoembolization (TACE); Group B (N = 35), TACE + RT; Group C (N = 50), hepatic arterial infusion chemotherapy; and Group D (n = 149), concurrent chemoradiotherapy (CCRT). RESULTS AND CONCLUSIONS: The median follow-up period was 27.8 months (range, 12.9-121.9 months). The median overall survival (OS) was longer in Groups B (15.3 months) and D (12.8 months) than in Groups A (7.5 months) and C (8.2 months; Group B vs. A, Bonferroni corrected P [P(c)] = 0.04; Group B vs. C, P(c) = 0.02; Group D vs. A, P(c) = 0.01; Group D vs. C, Pc = 0.006). Groups B and D also showed superior progression-free survival (PFS) and intrahepatic control than Groups A and C. In multivariate analysis, tumour multiplicity, serum alpha-foetoprotein level (≥200 ng/ml) and initial treatment were independent prognostic factors for OS and PFS. Patients with huge unresectable HCCs treated with RT, either as CCRT or in combination with TACE, showed excellent intrahepatic control and prolonged survival. RT could be considered a promising treatment modality in these patients.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/liv.12436/abstract
DOI
10.1111/liv.12436
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Mi Sun(김미선)
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Chang, Jee Suk Paul(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98537
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