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A multicenter retrospective cohort study of practice patterns and clinical outcome on radiotherapy for hepatocellular carcinoma in Korea
Author(s) -
Seong Jinsil,
Lee Ik Jae,
Shim Su Jung,
Lim Do Hoon,
Kim Tae Hyun,
Kim Jong Hoon,
Jang Hong Seok,
Kim Mi Sook,
Chie Eui Kyu,
Kim Jin Hee,
Nam TaekKeun,
Lee Hyung Sik,
Han Chul Joo
Publication year - 2009
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2008.01873.x
Subject(s) - medicine , hepatocellular carcinoma , radiation therapy , retrospective cohort study , multivariate analysis , stage (stratigraphy) , liver function , survival rate , oncology , paleontology , biology
Aim: To determine the national practice processes of care and outcomes of radiotherapy for hepatocellular carcinoma (HCC) in Korea. Patients and Methods: A national survey of 53 institutions nationwide was conducted by requesting data on their experience of radiotherapy for HCC. Among them, 10 institutions were selected for performing more detailed analysis, based on the radiotherapy experience of at least five HCC patients between 2004 and 2005. Results: This study covered the treatment of 398 HCC patients for 2 years. Most patients (78%) were in stage III or IV. Radiotherapy was chosen after the failure of other treatments, most frequently transarterial chemoembolization. Radiotherapy was performed predominantly using the three‐dimensional conformal technique (3D‐CRT, 81.9%) mostly with a total dose of ≥45 Gy. In 9.3% of the patients, radiotherapy was performed using radiosurgery. In a biologically effective dose (BED) with 10 Gy of α/β, 4.2–124.3 Gy 10 was delivered. The median survival time was 12 months, and the 2‐year overall survival rate was 27.9%. A tumour size <5 cm, a negative lymph node and BED >53.1 Gy 10 were shown by multivariate analysis to be significant factors for a better prognosis. In a subset analysis for the 326 patients treated with 3D‐CRT, better liver function with Child–Pugh class A was shown to be an additional factor for a better prognosis. Conclusions: Radiotherapy has been used to treat advanced HCC in various modes, but mostly as a salvage treatment. Although this study was retrospective, it indicates that radiotherapy is a quite effective modality for HCC patients.