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Updated: Sep 11, 2025
Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
Effectiveness of Radiotherapy for Hepatocellular Carcinoma with Lymph Node Metastasis: A Meta-Analysis
Sooyoung Hwang1, Seoon Hur1, Won Sup Yoon1,2
1Korea University College of Medicine, Seoul, Korea.
Purpose:
Lymph node metastasis (LNM) of hepatocellular carcinoma (HCC) carries a poor prognosis; however, no standard treatment has been established. Radiotherapy (RT) has demonstrated favorable tumor response, with the advantage of being less affected by anatomical hindrances.
Materials And Methods:
Databases were searched up to April 2024. The inclusion criteria were ≥ 5 patients with HCC LNM, studies that performed external RT, and reporting survival or response rate (RR). The main effect measures are pooled 1- and 2-year overall survival (OS) rates, RR, and grade ≥ 3 complications.
Results:
Twelve studies involving 825 patients were included. The pooled 1-year OS rate and 2-year OS rate were 49.3% (95% confidence interval [CI], 39.2 to 59.4) and 24.5% (95% CI, 17.0 to 34.0), respectively. The median OS ranged from 5.8 to 29.7 months, with a median value of 9.7 months. In one study, 14.7% of patients were prescribed an immunoagent. In other studies, some patients received sorafenib, but no specific systemic therapy was performed for the majority. The pooled RR was 75.1% (95% CI, 66.9 to 81.8). The pooled RR of high dose and low dose groups was 83.8% (95% CI, 76.3 to 89.3) vs. 55.6% (95% CI, 44.4 to 66.3), respectively (p < 0.001). The pooled rate of grade ≥ 3 gastrointestinal toxicity was 3.7% (95% CI, 2.1 to 6.6).
Conclusion:
RT is an effective and feasible palliative option for HCC LNM. Further research of combined treatment with novel systemic agents are necessary.
