Clinical impact of carbon‐ion radiotherapy on hepatocellular carcinoma with Child‐Pugh B cirrhosis

BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) patients with Child‐Pugh (CP)‐B not eligible for surgery nor other focal therapy options due to impaired liver function, have very limited treatment options. This study aims to retrospectively investigate the toxicity and efficacy of Carbon‐ion radiotherapy (C‐ion RT) on HCC with CP‐B patients. MATERIALS AND METHODS: Patients with CP‐B, no extrahepatic metastasis, and treated with C‐ion RT between May 2000 and March 2020 were retrospectively extracted and included in this study. RESULTS: Sixty‐nine lesions of 58 patients were included. The median follow‐up duration was 20.5 (2.7–108) months. During follow‐up, recurrence was observed in 43 patients, including 2 local recurrences and 39 intrahepatic recurrences beyond the irradiation field. A grade 3 acute hepatotoxicity was observed in one patient during the observation period. No acute or late adverse event of grade ≥4 was observed. Overall survival was 80.4% and 46.0% at 1 and 2 years, respectively, and the median survival time was 22.6 months. Local control rate was 96.4% at both 1 and 2 years, and progression‐free survival was 38.6% and 6.9% at 1 and 2 years, respectively, with a median of 9.7 months. CONCLUSION: The C‐ion RT showed low toxicity and good local effect in patients with HCC and CP‐B. Therefore, C‐ion RT could be an appropriate treatment for patients with HCC with poor liver function.