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Palliative Liver Radiotherapy (RT) for Symptomatic Hepatocellular Carcinoma (HCC)
Cynthia S Y Yeung1, C L Chiang2,3,4, Natalie S M Wong1
1Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong (SAR), China.
Scientific Reports
|January 29, 2020
Summary
Single dose palliative liver radiotherapy (RT) offers symptom relief for patients with symptomatic hepatocellular carcinoma (HCC). This treatment is well-tolerated, with approximately half of patients experiencing symptom improvement and minimal toxicity.
Area of Science:
- Hepatobiliary Medicine
- Radiation Oncology
- Gastroenterology
Background:
- Hepatocellular carcinoma (HCC) is a significant global health concern.
- Symptomatic HCC patients often require palliative treatment options.
- Existing treatments like trans-arterial chemoembolization (TACE) and stereotactic body radiotherapy (SBRT) may not be suitable for all patients.
Purpose of the Study:
- To evaluate the effectiveness of single-dose palliative liver radiotherapy (RT) in managing symptoms of HCC.
- To assess the duration of symptom response and treatment-related toxicities.
- To determine the impact of palliative RT on alpha-feto protein (AFP) levels and radiological response.
Main Methods:
- Retrospective review of unresectable HCC patients treated with palliative liver RT.
- Inclusion criteria: refractory or unsuitable for TACE/SBRT, with pain or abdominal discomfort as the index symptom.
- Outcomes measured: symptom improvement at 1 month, response duration, toxicities, AFP response, and radiological response.
Main Results:
- 52 patients were included; 65.4% presented with pain, 34.6% with abdominal discomfort.
- Clinical improvement of index symptoms was observed in 51.9% of patients at 1 month.
- Median symptom progression time was 89 days; median response duration was 3 months.
- Treatment was well-tolerated, with only 3.8% experiencing grade 3 gastrointestinal toxicities.
- AFP response, radiological response, and disease control rates at 3 months were 48.6%, 15.1%, and 54.5%, respectively.
Conclusions:
- Single-dose palliative liver RT provides significant symptom relief for a substantial proportion of symptomatic HCC patients.
- The treatment demonstrates a favorable safety profile with minimal toxicity.
- Palliative liver RT is a viable option for HCC patients unsuitable for TACE or SBRT, improving quality of life.
