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Abstract
We investigated the clinical efficacy of stereotactic ablative radiotherapy (SABR) in patients with oligometastatic hepatocellular carcinoma (HCC). The inclusion criteria were patients receiving definitive treatment for HCC with 1-5 metastatic lesions, <3 metastases in a single organ and receiving radiotherapy with fraction doses ≥6 Gy. A total of 100 patients with 121 metastatic lesions were reviewed. The most common site of metastasis was the bones (40%), followed by the lungs (38%). Systemic therapy was administered to 71% of patients. With a median follow-up of 13 months, the median overall survival (OS) was 16 months. The 2-year OS rate was 40%. The prognostic factors in univariate analysis were performance status, Child-Pugh class, primary HCC status, and time interval of metastasis. Performance status and Child-Pugh class remained in multivariate analysis. OS differed significantly depending on the number of prognostic factors: 46 months in patients with both factors (Group 1), 13 months with one factor (Group 2), and 6 months with no risk factor (Group 3) (p < 0.001). Nine patients experienced grade 1 radiation pneumonitis. Given its efficacy and safety, SABR deserves active consideration in the treatment of oligometastatic HCC.

Affiliations

Tae Hyung Kim 1 2, Taek-Keun Nam 3, Sang Min Yoon 4, Tae Hyun Kim 5, Young Min Choi 6, Jinsil Seong 1
1Departments of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
2Department of Radiation Oncology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Republic of Korea.
3Department of Radiation Oncology, Chonnam National University Medical School, Gwangju 61469, Republic of Korea.
4Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
5Center for Proton Therapy, National Cancer Center, Goyang 10408, Republic of Korea.
6Department of Radiation Oncology, Dong-A University College of Medicine, Busan 49201, Republic of Korea.