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Influence of liver toxicities on prognosis after stereotactic body radiation therapy for hepatocellular carcinoma
Author(s) -
Sanuki Naoko,
Takeda Atsuya,
Oku Yohei,
Eriguchi Takahisa,
Nishimura Shuichi,
Aoki Yosuke,
Kunieda Etsuo
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12383
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , univariate analysis , radiosurgery , radiation therapy , oncology , multivariate analysis , surgery
Aim To better define clinically relevant non‐classic radiation‐induced liver disease ( RILD ) following stereotactic body radiotherapy ( SBRT ) in patients with small hepatocellular carcinoma ( HCC ). Methods We retrospectively evaluated the influence of acute liver toxicities on fatal hepatic failure in HCC patients treated with SBRT . Between A pril 2006 and F ebruary 2012, 194 HCC were treated with SBRT . Among them, patients followed up for more than 6 months were eligible. Laboratory results and C hild– P ugh ( CP ) scores were obtained before treatment and at monthly follow‐up visits. Toxicities were evaluated by the C ommon T erminology C riteria for A dverse E vents version 4.0. Possible definitions of RILD were evaluated with respect to fatal hepatic failure within 12 months. Results One hundred and eighty HCC were evaluated with a median follow‐up of 28.2 months. Fatal hepatic failure within 12 months occurred in eight patients (4%). On univariate analysis, grade 3 or more elevated transaminases, CP score of 8 or more, and/or grade 3 or more decreased platelet count significantly predicted fatal hepatic failure within 12 months. Combinations of these factors (i.e. having at least one criterion) also predicted fatal hepatic failure within 12 months (16% with criteria vs 1% without criteria). Two‐year overall survival rates for patients with and without RILD was 64.9% and 83.8% ( P < 0.001), respectively. Conclusion We identified three criteria that affected overall survival in HCC patients treated with SBRT . Further prospective studies are warranted to validate the safety and effect of SBRT for HCC .