RT Journal Article
SR Electronic
T1 Clinical Outcomes of Patients Receiving Stereotactic Body Radiotherapy Dose De-escalation for Hepatocellular Carcinoma at the Hepatic Hilum
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 1159
OP 1169
DO 10.21873/anticanres.17503
VO 45
IS 3
A1 FUJISAWA, TAKESHI
A1 HOJO, HIDEHIRO
A1 NAKAMURA, MASAKI
A1 MAKITA, KENJI
A1 HIRATA, HIDENARI
A1 OYOSHI, HIDEKAZU
A1 TOMIZAWA, KENTO
A1 ZHOU, YUZHENG
A1 FUKUSHI, KEIKO
A1 IKEDA, MASAFUMI
A1 ZENDA, SADAMOTO
YR 2025
UL http://ar.iiarjournals.org/content/45/3/1159.abstract
AB Background/Aim: Stereotactic body radiation therapy (SBRT) for centrally located hepatocellular carcinomas (HCCs) can cause severe central biliary toxicity. However, dose de-escalation SBRT has the potential to reduce biliary toxicity with excellent tumor control. Therefore, we aimed to retrospectively evaluate the efficacy and toxicity of de-escalated SBRT in patients with hepatic hilum HCC.Patients and Methods: Patients diagnosed with peripherally located HCC received SBRT (40 Gy in five fractions), and those with centrally located HCC received de-escalated SBRT (35 Gy in five fractions) between January 2016 and August 2023 in National Cancer Center Hospital East.Results: Of the total 42 consecutive patients evaluated, 16 (38%) were diagnosed with centrally located HCC. The median observation time was 25 months (interquartile range=10-43). The 2-year cumulative incidences of local recurrence were 17.3% and 8.1% in patients with centrally and peripherally located HCC, respectively. No statistically significant differences were observed in the cumulative incidence of local recurrence, OS, or PFS between patients with centrally and peripherally located HCC. Univariate analysis of OS showed that a smaller clinical target volume of <20 ml was significantly associated with a better OS compared to a larger volume (p=0.017). No patient experienced grade 3 or higher treatment-related adverse events.Conclusion: Dose de-escalation SBRT for centrally located HCC showed good local control with no grade 3 or more RT related toxicities, suggesting it may be a safe alternative.