Stereotactic body radiation therapy as an ablative treatment for inoperable hepatocellular carcinoma

Abstract Purpose To describe efficacy and safety of stereotactic body radiation therapy (SBRT) for the treatment of inoperable hepatocellular carcinoma. Methods The records of 77 consecutive patients treated with SBRT for 97 liver-confined HCC were reviewed. A total dose of 45 Gy in 3 fractions was prescribed to the 80% isodose line. Local control (LC), overall survival (OS), progression-free survival (PFS) and toxicity were studied. Results The median follow-up was 12 months. The median tumor diameter was 2.4 cm. The LC rate was 99% at 1 and 2 years. The 1 and 2-year OS were 81.8% and 56.6% respectively. The median time to progression was 9 months (0–38). The rate of hepatic toxicity was 7.7% [1.6–13.7], 14.9% [5.7–23.2] and 23.1% [9.9–34.3] at 6 months, 1 year and 2 years respectively. In multivariate analysis, female gender (HR 7.87 [3.14–19.69]), a BCLC B-C stage (HR 3.71 [1.41–9.76]), a sum of all lesion diameters ⩾2 cm (HR 7.48 [2.09–26.83]) and a previous treatment (HR 0.10 [0.01–0.79]) were independent prognostic factors of overall survival. Conclusion SBRT allows high local control for inoperable hepatocellular carcinomas. It should be considered when an ablative treatment is indicated in Child A patients.