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Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05)
PURPOSE: There is limited data on radiotherapy (RT) for hepatocellular carcinoma (HCC) in patients with Child-Pugh classification B (CP-B). This study aimed to evaluate the treatment outcomes of fractionated conformal RT in HCC patients with CP-B. MATERIALS AND METHODS: We retrospectively reviewed t...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Cancer Association
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790850/ https://www.ncbi.nlm.nih.gov/pubmed/30971065 http://dx.doi.org/10.4143/crt.2018.687 |
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author | Bae, Sun Hyun Park, Hee Chul Yoon, Won Sup Yoon, Sang Min Jung, In-Hye Lee, Ik Jae Kim, Jun Won Seong, Jinsil Kim, Tae Hyun Nam, Taek-Keun Choi, Youngmin Lee, Sun Young Jang, Hong Seok Lee, Dong Soo Kim, Jin Hee |
author_facet | Bae, Sun Hyun Park, Hee Chul Yoon, Won Sup Yoon, Sang Min Jung, In-Hye Lee, Ik Jae Kim, Jun Won Seong, Jinsil Kim, Tae Hyun Nam, Taek-Keun Choi, Youngmin Lee, Sun Young Jang, Hong Seok Lee, Dong Soo Kim, Jin Hee |
author_sort | Bae, Sun Hyun |
collection | PubMed |
description | PURPOSE: There is limited data on radiotherapy (RT) for hepatocellular carcinoma (HCC) in patients with Child-Pugh classification B (CP-B). This study aimed to evaluate the treatment outcomes of fractionated conformal RT in HCC patients with CP-B. MATERIALS AND METHODS: We retrospectively reviewed the data of HCC patients with CP-B treated with RT between 2009 and 2014 at 13 institutions in Korea. HCC was diagnosed by the Korea guideline of 2009, and modern RT techniques were applied. Fraction size was ≤ 5 Gy and the biologically effective dose (BED) ≥ 40 Gy(10) (α/β = 10 Gy). A total of 184 patients were included in this study. RESULTS: Initial CP score was seven in 62.0% of patients, eight in 31.0%, and nine in 7.0%. Portal vein tumor thrombosis was present in 66.3% of patients. The BED ranged from 40.4 to 89.6 Gy(10) (median, 56.0 Gy(10)). After RT completion, 48.4% of patients underwent additional treatment. The median overall survival (OS) was 9.4 months. The local progression-free survival and OS rates at 1 year were 58.9% and 39.8%, respectively. In the multivariate analysis, non-classic radiation-induced liver disease (RILD) (p < 0.001) and additional treatment (p < 0.001) were the most significant prognostic factors of OS. Among 132 evaluable patients without progressive disease, 19.7% experienced non-classic RILD. Normal liver volume was the most predictive dosimetric parameter of non-classic RILD. CONCLUSION: Fractionated conformal RT showed favorable OS with a moderate risk non-classic RILD. The individual radiotherapy for CP-B could be cautiously applied weighing the survival benefits and the RILD risks. |
format | Online Article Text |
id | pubmed-6790850 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Korean Cancer Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-67908502019-10-21 Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05) Bae, Sun Hyun Park, Hee Chul Yoon, Won Sup Yoon, Sang Min Jung, In-Hye Lee, Ik Jae Kim, Jun Won Seong, Jinsil Kim, Tae Hyun Nam, Taek-Keun Choi, Youngmin Lee, Sun Young Jang, Hong Seok Lee, Dong Soo Kim, Jin Hee Cancer Res Treat Original Article PURPOSE: There is limited data on radiotherapy (RT) for hepatocellular carcinoma (HCC) in patients with Child-Pugh classification B (CP-B). This study aimed to evaluate the treatment outcomes of fractionated conformal RT in HCC patients with CP-B. MATERIALS AND METHODS: We retrospectively reviewed the data of HCC patients with CP-B treated with RT between 2009 and 2014 at 13 institutions in Korea. HCC was diagnosed by the Korea guideline of 2009, and modern RT techniques were applied. Fraction size was ≤ 5 Gy and the biologically effective dose (BED) ≥ 40 Gy(10) (α/β = 10 Gy). A total of 184 patients were included in this study. RESULTS: Initial CP score was seven in 62.0% of patients, eight in 31.0%, and nine in 7.0%. Portal vein tumor thrombosis was present in 66.3% of patients. The BED ranged from 40.4 to 89.6 Gy(10) (median, 56.0 Gy(10)). After RT completion, 48.4% of patients underwent additional treatment. The median overall survival (OS) was 9.4 months. The local progression-free survival and OS rates at 1 year were 58.9% and 39.8%, respectively. In the multivariate analysis, non-classic radiation-induced liver disease (RILD) (p < 0.001) and additional treatment (p < 0.001) were the most significant prognostic factors of OS. Among 132 evaluable patients without progressive disease, 19.7% experienced non-classic RILD. Normal liver volume was the most predictive dosimetric parameter of non-classic RILD. CONCLUSION: Fractionated conformal RT showed favorable OS with a moderate risk non-classic RILD. The individual radiotherapy for CP-B could be cautiously applied weighing the survival benefits and the RILD risks. Korean Cancer Association 2019-10 2019-04-10 /pmc/articles/PMC6790850/ /pubmed/30971065 http://dx.doi.org/10.4143/crt.2018.687 Text en Copyright © 2019 by the Korean Cancer Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Bae, Sun Hyun Park, Hee Chul Yoon, Won Sup Yoon, Sang Min Jung, In-Hye Lee, Ik Jae Kim, Jun Won Seong, Jinsil Kim, Tae Hyun Nam, Taek-Keun Choi, Youngmin Lee, Sun Young Jang, Hong Seok Lee, Dong Soo Kim, Jin Hee Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05) |
title | Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05) |
title_full | Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05) |
title_fullStr | Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05) |
title_full_unstemmed | Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05) |
title_short | Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05) |
title_sort | treatment outcome after fractionated conformal radiotherapy for hepatocellular carcinoma in patients with child-pugh classification b in korea (krog 16-05) |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790850/ https://www.ncbi.nlm.nih.gov/pubmed/30971065 http://dx.doi.org/10.4143/crt.2018.687 |
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