Stereotactic body radiation therapy for elderly patients with small hepatocellular carcinoma: a retrospective observational study

• Published in: Journal of liver cancer 2022-09, Vol.22 (2), p.136-145
• Main Authors: Jang, Jeong Yun, Jung, Jinhong, Lee, Danbi, Shim, Ju Hyun, Kim, Kang Mo, Lim, Young-Suk, Lee, Han Chu, Park, Jin-Hong, Yoon, Sang Min
• Format: Article
• Language: English
• Subjects: carcinoma, hepatocellular; elderly; Original; radiotherapy, stereotactic body; survival
• ISSN: 2288-8128; 2383-5001
• DOI: 10.17998/jlc.2022.08.18

We aimed to investigate the efficacy and safety of stereotactic body radiation therapy (SBRT) in elderly patients with small hepatocellular carcinomas (HCC). Eighty-three patients (89 lesions) with HCC who underwent SBRT between January 2012 and December 2018 were reviewed in this retrospective observational study. The key inclusion criteria were as follows: 1) age ≥75 years, 2) contraindications for hepatic resection or percutaneous ablative therapies, 3) no macroscopic vascular invasion, and 4) no extrahepatic metastasis. The patients were 75-90 years of age, and 49 (59.0%) of them were male. Most patients (94.0%) had an Eastern Cooperative Oncology Group performance status of 0 or 1. Seventy-four patients (89.2%) had Child-Pugh class A hepatic function before SBRT. The median tumor size was 1.6 cm (range, 0.7-3.5). The overall median follow-up period was 34.8 months (range, 7.3-99.3). The 5-year local tumor control rate was 90.1%. The 3-year and 5-year overall survival rate was 57.1% and 40.7%, respectively. Acute toxicity grade ≥3 was observed in three patients (3.6%) with elevated serum hepatic enzymes; however, no patient experienced a worsening of the Child-Pugh score to ≥2 after SBRT. None of the patients developed late toxicity (grade ≥3). SBRT is a safe treatment option with a high local control rate in elderly patients with small HCC who are not eligible for other curative treatments.