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Radiat Oncol J. 2015 Mar;33(1):36-41. English. Original Article. https://doi.org/10.3857/roj.2015.33.1.36
Kim KS , Kim K , Chie EK , Kim YJ , Yoon JH , Lee HS , Ha SW .
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. kyubokim@snu.ac.kr
Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
Departrment of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Abstract

PURPOSE: To evaluate the incidence and risk factors of post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Medical records of 81 patients who have been diagnosed of brain metastases from HCC and underwent surgery, radiosurgery and/or whole brain radiotherapy (WBRT) between January 2000 and December 2013 were retrospectively reviewed. RESULTS: Intracranial hemorrhage was present in 64 patients (79%) at the time of diagnosis. Median value of alpha-fetoprotein (AFP) level was 1,700 ng/mL. The Eastern Cooperative Oncology Group (ECOG) performance status for 20 patients was greater than 2. Fifty-seven patients underwent WBRT and the others were treated with surgery and/or radiosurgery without WBRT. During follow-up, 12 events of intracranial hemorrhage after treatment were identified. Three-month post-treatment hemorrhage rate was 16.1%. Multivariate analyses revealed that ECOG performance status, AFP, and WBRT were associated with post-treatment hemorrhage (p = 0.013, 0.013, and 0.003, respectively). Kaplan-Meier analysis showed that 3-month post-treatment hemorrhage rate of new lesion was higher in patients treated without WBRT, although statistical significance was not reached. (18.6% vs. 4.6%; p = 0.104). Ten of 12 patients with post-treatment hemorrhage died with neurologic cause. CONCLUSION: WBRT should be considered to prevent post-treatment hemorrhage in the treatment of brain metastases from HCC.

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