J Liver Cancer.  2022 Sep;22(2):136-145. 10.17998/jlc.2022.08.18.

Stereotactic body radiation therapy for elderly patients with small hepatocellular carcinoma: a retrospective observational study

• Jang JY
• Jung J
• Lee D
• Shim JH
• Kim KM
• Lim YS
• Lee HC
• Park Jh
• Yoon SM

• KMID: 2534240
• DOI: http://doi.org/10.17998/jlc.2022.08.18

Abstract

Background
/Aim: We aimed to investigate the efficacy and safety of stereotactic body radiation therapy (SBRT) in elderly patients with small hepatocellular carcinomas (HCC).
Methods
Eighty-three patients (89 lesions) with HCC who underwent SBRT between January 2012 and December 2018 were reviewed in this retrospective observational study. The key inclusion criteria were as follows: 1) age ≥75 years, 2) contraindications for hepatic resection or percutaneous ablative therapies, 3) no macroscopic vascular invasion, and 4) no extrahepatic metastasis.
Results
The patients were 75-90 years of age, and 49 (59.0%) of them were male. Most patients (94.0%) had an Eastern Cooperative Oncology Group performance status of 0 or 1. Seventy-four patients (89.2%) had Child-Pugh class A hepatic function before SBRT. The median tumor size was 1.6 cm (range, 0.7-3.5). The overall median follow-up period was 34.8 months (range, 7.3-99.3). The 5-year local tumor control rate was 90.1%. The 3-year and 5-year overall survival rate was 57.1% and 40.7%, respectively. Acute toxicity grade ≥3 was observed in three patients (3.6%) with elevated serum hepatic enzymes; however, no patient experienced a worsening of the Child-Pugh score to ≥2 after SBRT. None of the patients developed late toxicity (grade ≥3).
Conclusions
SBRT is a safe treatment option with a high local control rate in elderly patients with small HCC who are not eligible for other curative treatments.

Keyword

Carcinoma, hepatocellular; Radiotherapy, stereotactic body; Elderly; Survival

Figure

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  Figure 1. Flow diagram depicting the inclusion of the patients in the current study.

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  Figure 2. Local control (A), overall survival (B), intrahepatic recurrence-free survival (C) rates after stereotactic body radiation therapy in elderly patients with hepatocellular carcinoma.

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