Stereotactic radiotherapy for brain metastases of hepatocellular carcinoma

Abstract

Objective To analyze the effects of stereotactic radiotherapy (SRT) with or without whole-brain radiotherapy (WBRT) in the treatment of limited number brain metastasis of hepatocellular carcinoma. Methods A retrospective analysis of 75 hepatocellular carcinoma patients with brain metastases within 4 lesions. 45 cases were treated with SRT alone and 30 cases were treated with SRT+ WBRT. Tumor response rate, overall survival and radiotherapy side effects of the two groups were compared. Multivariate analysis was made for overall survival. Results Tumor response rates of SRT group and WBRT+ SRT group were 88.9% and 80.0%, respectively. No significant differences were found between the two groups(P=0.537). For the whole patients, the median overall survival time was 5.7 months. There was no difference between SRT group and SRT+ WBRT group (6.2 months vs 5.4 months, P=0.380). Multivariate analysis showed that the number(P=0.041), the total volume of lesions (P=0.012) and the control situations of intrahepatic tumors (P=0.006) were the main factors affecting overall survival of the patients. No serious side effects were found in either of two groups. Conclusions Stereotactic radiotherapy is an effective and safe treatment for limited number brain metastases of hepatocellular carcinoma. Patients who accepted SRT alone or SRT+ WBRT have a similar tumor response rate and overall survival time. Key words: Brain metastases; Hepatocellular carcinoma; Whole-brain radiotherapy; Stereotactic radiotherapy