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  • [J Cancer Res Clin Oncol .] Improved oncologic outcomes by ablative radiotherapy in patients with bone metastasis from hepatocellular carcinoma

    연세의대 / 김태형, 성진실*

  • 출처
    J Cancer Res Clin Oncol .
  • 등재일
    2021 Sep
  • 저널이슈번호
    147(9):2693-2700. doi: 10.1007/s00432-021-03553-2.
  • 내용

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    Abstract
    Purpose: For bone metastasis from hepatocellular carcinoma (HCC), radiotherapy (RT) has been used a palliative treatment with little impact on survival. Currently, ablative RT is popularly used, and a more than palliative effect is expected. Herein, we investigated the clinical efficacy of ablative RT in patients with bone metastasis from HCC.

    Methods: In total, 530 patients with 887 lesions treated in 1992-2019 were reviewed. Oligometastasis was defined as the presence of < 5 lesions. Total doses were normalized to obtain biologically effective doses (BEDs). The cut-off threshold of the BED was determined via receiver operating characteristics curve analysis. The Kaplan-Meier method was used to calculate overall survival (OS); propensity score matching (PSM) was performed to balance the heterogeneity in cases while comparing BEDs of ≥ 60 and < 60 Gy.

    Results: The most common site of metastasis was the spine (59%); 59 patients (11%) presented with oligometastasis, and 76.2% of patients showed objective pain palliation after RT. Median OS was 5.1 months for all patients; patients with oligometastasis showed longer OS than those without (9.8 vs. 4.7 months). A Cox proportional hazards model showed that performance status, Child-Pugh class, extraosseous metastasis, primary HCC status, α-fetoprotein level, and radiation dose (BED) were significant prognostic factors. Post PSM, BED was the only treatment-related prognostic factor that remained significant; the median OS durations were 8.1 and 4.4 months when the BEDs were ≥ 60 and < 60 Gy, respectively.

    Conclusion: Ablative RT improved OS and pain palliation in patients with bone metastasis from HCC.

     

  • 키워드
    Ablative dose; Bone metastasis; Oligometastasis; Overall survival; Radiotherapy.
  • 편집위원

    간암의 뼈전이에서 방사선량에 따른 예후를 분석하였으며, BED 60 이상의 고선량방사선치료가 생존율 향상과 통증 완화에 이득이 있음을 보고함.

    2021-10-19 14:43:54

  • 편집위원2

    HCC에서 동반되는 bone metastases는 bulky, soft tissue mass forming lesion인 경우가 많은데, 이때 고선량의 방사선치료를 적용할 수 있는 좋은 근거연구로 생각됩니다.

    2021-10-19 14:46:37

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