Abstract
Background: No studies evaluating the clinical outcomes of radiotherapy (RT) for hepatocellular carcinoma (HCC) in the caudate lobe have been available to date. The purpose of this study was to evaluate the effectiveness and safety of RT for HCC in the caudate lobe.Material and Methods: Seventy patients with HCC in the caudate lobe treated with RT from a multi-institutional database were included in this study. The median equivalent dose in 2 Gy (EQD2) was 80.0 Gy10 (range, 31.3–99.3), and freedom from local progression (FFLP), progression-free survival (PFS), and overall survival (OS) rates were evaluated.Results: The median time of follow-up was 47.9 months (range, 3.4–127), and the 5-year FFLP, PFS, and OS rates were 80.6% [95% confidence interval (CI), 70.8–91.8], 13.8% (95% CI, 7.5–25.4), and 51.3% (95% CI, 39.9–66.1), respectively. In the multivariate analysis, the radiation dose was significantly associated with the FFLP rate [hazard ratio (HR), 0.57 per 10 Gy10 increase, p = 0.001], and the status of FFLP was significantly associated with OS (HR, 2.694, p = 0.014). The overall rate of ≥grade 3 adverse events was 5.7% (4 of 70), and RT-related mortality was not observed.Conclusion: RT for HCC in the caudate lobe showed promising FFLP and OS rates with safe toxicity profiles. These findings suggest that RT may be a promising treatment option for HCC in the caudate lobe.
Highlights
Surgical resection is known as the curative treatment for hepatocellular carcinoma (HCC), but it is suitable for
The diagnosis of HCC was based on histologic findings and/or radiologic criteria of the American Association for the Study of Liver Diseases [3], and the location of the tumor was defined based on the Couinaud nomenclature using dynamic computed tomography (CT) and magnetic resonance imaging (MRI) [31]
Surgical resection of the caudate lobe with adjacent hemilobes or other segments to achieve complete resection with sufficient margins may be feasible in HCC patients with good liver function, but limited surgical resection of the caudate lobe has been attempted because most HCC patients have chronic hepatitis or cirrhosis [5,6,7,8,9]
Summary
Surgical resection is known as the curative treatment for hepatocellular carcinoma (HCC), but it is suitable for
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