Oncotarget

Clinical Research Papers:

Identifying the optimal criteria of radiotherapeutic parameters for patients with unresectable locally advanced hepatocellular carcinoma

Seok Hyun Son _, Hong Seok Jang, Soo Yoon Sung, Hye Jin Kang, Sojung Lee and Chul Seung Kay

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Oncotarget. 2015; 6:42372-42379. https://doi.org/10.18632/oncotarget.5713

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Abstract

Seok Hyun Son1, Hong Seok Jang2, Soo Yoon Sung1, Hye Jin Kang1, Sojung Lee1, Chul Seung Kay1

1Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

2Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to:

Chul Seung Kay, e-mail: [email protected]

Keywords: hepatocellular carcinoma, radiotherapy, optimal criteria, radiotherapeutic parameters

Received: July 30, 2015     Accepted: October 05, 2015     Published: October 16, 2015

ABSTRACT

The purpose of this study is to identify the optimal criteria of the radiotherapeutic parameters in patients with unresectable locally advanced hepatocellular carcinoma (HCC). 103 patients were enrolled in this study. All patients received RT delivered using the TomoTherapy Hi-Art system between March 2006 and February 2012. We evaluated the planning target volume (PTV), total dose (Gy10), and NTNL-VBED20 (non-target normal liver volume receiving more than a biologically effective dose of 20 Gy8) as significant radiotherapeutic parameters associated with hepatic function deterioration and local progression-free survival (PFS). A PTV of 279 cm3 or 304 cm3, a total dose of 60 Gy10, and a NTNL-VBED20 of 40.8% were identified as the optimal cut-off values of radiotherapeutic parameters to prevent hepatic function deterioration and prolong local PFS. Based on these findings, patients were divided in a favorable and an unfavorable prognosis group. The differences in median local PFS, overall survival, and incidence of deteriorated hepatic function between the two groups were 11.2 months, 11.1 months, and 71.7%, respectively (p < 0.001 in each case). In conclusion, we suggest that the optimal criteria of the radiotherapeutic parameters for patients with unresectable locally advanced HCC are: PTV ≤ 279 cm3, total dose > 60 Gy10, and NTNL-VBED20 ≤ 40.8%.


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