Stereotactic body radiotherapy for patients with small hepatocellular carcinoma ineligible for resection or ablation therapies

AimTo evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) in patients with small hepatocellular carcinoma (HCC) who were ineligible for resection or ablation therapies. MethodsOverall, 65 patients with 74 HCC (median tumor size, 16mm) were enrolled. They were treated at the prescribed dose of 48Gy in four fractions at the isocenter. Child-Turcotte-Pugh (CTP) scoring was used to classify 56 and nine patients into classes A and B, respectively. Local progression was defined as irradiated tumor growth on a dynamic computed tomography follow up. The median follow-up period was 26 months. Tumor responses were assessed according to the modified Response Evaluation Criteria in Solid Tumors. Treatment-related toxicities were evaluated according to the Common Terminology Criteria for Adverse Events version 4.0. ResultsThe 2-year overall survival, progression-free survival and local control rates were 76.0% (95% confidence interval [CI], 65.4-86.7%), 40.0% (95% CI, 27.6-52.3%) and 100% (95% CI, 100%), respectively. At 6-12 months after SBRT, grade 3 or higher toxicities was observed in 15 (23.1%) patients. The incidence of grade 3 or higher toxicities was higher in CTP class B than in class A (P=0.0127). ConclusionSBRT was effective and relatively safe for patients with small HCC who were ineligible for resection or ablation therapies.