Research Papers:
High-dose radiotherapy is associated with better local control of bone metastasis from hepatocellular carcinoma
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Abstract
In-Hye Jung1, Sang Min Yoon1, Jungwon Kwak1, Jin-Hong Park1, Si Yeol Song1, Sang-Wook Lee1, Seung Do Ahn1, Eun Kyung Choi1, Jong Hoon Kim1
1Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Correspondence to:
Sang Min Yoon, email: [email protected]
Keywords: hepatocellular carcinoma, bone metastasis, palliative treatment, radiotherapy, dose-response relationship
Received: June 15, 2016 Accepted: January 16, 2017 Published: January 27, 2017
ABSTRACT
We evaluated the pain and radiologic response, time to progression, and dose-response relationship after palliative radiotherapy for bone metastasis from hepatocellular carcinoma. We retrospectively reviewed the medical records of 91 patients between January 2004 and August 2012. The reviewed medical records included data on changes in pain, local tumor progression, and radiologic response evaluated via follow-up images. The radiologic response was assessed based on the Response Evaluation Criteria In Solid Tumors. The pain response was defined according to the International Bone Metastases Consensus Working Party palliative radiotherapy endpoints. Median radiation dose was 40 Gy (range, 20–66 Gy), with various fraction sizes (range, 2.0–6.0 Gy). Pain response rate was 81.4%. During the follow-up periods, radiologic local tumor progression was found in 42 patients (46.2%). The median time to progression was 14.1 months. When the patients were divided into two groups according to their radiation dose (< 55 Gy10 vs. ≥ 55 Gy10), the pain response rates of the high- and low-dose groups did not differ significantly (p = 0.728). However, the radiologic response rate and the time to progression showed significant differences between the two groups (p = 0.009 and p = 0.018, respectively). With dose escalation, higher radiologic response rates and a longer time to progression were achieved in patients with mass-forming bone metastases from hepatocellular carcinoma.
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