Abstract
For treating hepatocellular carcinoma (HCC), local therapies and surgery, including liver transplant, are the first line treatment options; however, several contraindications limit their clinical use. The improvement of radiotherapy (RT) established RT in treating HCC contraindicated against local therapies, including transarterial chemoembolization and radiofrequency ablation. For HCC that recurs after RT and still contradicts against local therapies, there is a need to investigate the use of reirradiation. This study recruited patients receiving two courses of RT for recurrent HCC between January 2007 and December 2019. The result suggested that patients who experienced tumor regression after reirradiation had better survival over those with a stable form of the disease, with the mean overall survival (OS) as 30.0 and 4.0 months, respectively (p < 0.001). The analysis also revealed that systemic therapy had no benefit on both the OS and controlling distant metastasis; the result was limited to a small study number and diversity of drugs. Considering systemic therapy and portal vein tumor thrombosis, which are commonly viewed to affect prognosis, multivariate analysis suggested that the Child–Pugh score and local control were the only two independent factors for the OS, with p = 0.017 and p = 0.028, respectively. Our findings suggested that reirradiation could be the choice for treating recurrent HCC.
Highlights
IntroductionHepatocellular carcinoma (HCC) is one of the most common and lethal malignancies over the world [1,2]
Licensee MDPI, Basel, Switzerland.Hepatocellular carcinoma (HCC) is one of the most common and lethal malignancies over the world [1,2]
Building on the research mentioned above, we investigated the treatment outcome of reirradiation of recurrent hepatocellular carcinoma (HCC); survival and toxicity were reviewed in this retrospective study
Summary
Hepatocellular carcinoma (HCC) is one of the most common and lethal malignancies over the world [1,2]. Hepatitis B or C-induced liver cirrhosis, the most frequent risk factor for HCC, causes multifocal carcinogenesis and results in tumors developing in different hepatic lobes synchronously or metachronously [2,3]. Local therapies, including surgical excision, transarterial chemoembolization (TACE), radiofrequency ablation (RFA). Cryotherapy, may temporarily control the tumor [1,3,4]; larger tumors with. Little liver reserve, tumor numbers, tumor location and portal vein tumor thrombosis (PVTT) are common contraindications against the local therapies mentioned above. Recent improvements in radiotherapy (RT) have established RT in treating HCC, especially for larger tumors, tumors close to the diaphragm or in the presence of PVTT [4] A liver transplant is the solution for certain conditions as so; the difficulty of the surgery and the availability of liver donation limit the clinical use [4].
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