Radiat Oncol J.  2022 Mar;40(1):20-28. 10.3857/roj.2021.00934.

PIVKA-II as a surrogate marker for prognosis in patients with localized hepatocellular carcinoma receiving stereotactic body radiotherapy

• Cho IJ
• Jeong JU
• Nam TK
• Joo YE
• Cho SB
• Kim YH
• Song JY
• Yoon MS
• Ahn SJ
• Chung WK

• KMID: 2527625
• DOI: http://doi.org/10.3857/roj.2021.00934

Abstract

Purpose
This study aimed to determine the correlation between protein induced by vitamin K absence or antagonist-II (PIVKA-II) and stereotactic body radiotherapy (SBRT) in patients with hepatocellular carcinoma (HCC).
Materials and Methods
Sixty-one patients received SBRT between 2015 and 2020 with a median dose of 48 Gy (range, 39 to 60 Gy) with a median of 4 fractions. Changes in tumor markers before and after SBRT were analyzed.
Results
The median follow-up period was 31 months (range, 12 to 64 months). The estimated 2-year in-field failure-free survival, progression-free survival (PFS), and overall survival rates were 82.0%, 39.3%, and 96.7%, respectively. Patients with decreased PIVKA-II levels through SBRT had significantly few in-field failures (p = 0.005). Patients with PIVKA-II levels of ≤25 mAU/mL after SBRT had significantly long PFS (p = 0.004).
Conclusion
PIVKA-II could be a useful surrogate marker for response or survival outcomes in patients with localized HCC receiving SBRT.

Keyword

Stereotactic body radiotherapy; Hepatocellular carcinoma; PIVKA-II