[Radical radiation therapy of hepatocellular carcinoma]

Sixteen patients with residual or recurrent HCC following TAE were treated by radiation therapy (RTx). The total dose ranged from 58-64 Gy(TDF 99-113). RTx was performed between June 1988 and March 1991. A daily dose of 2 Gy, 5 days/week, or 3 Gy, 3 days/week, delivered by LINIAC 10 MV X-ray was selected. Tumors in the upper or lateral portion of the right lobe of the liver were selected in order to avoid radiation of the gastrointestinal organs. Liver function was evaluated by monitoring the clinical stage (General Rules for the Clinical and Pathological Study of Primary Liver Cancer, Liver Cancer Study Group of Japan) before and after RTx. Local control rates following RTx were 75% at 6 months, 45% at 1 year, 45% at 2 years and 36% at 3 years. Survival rates following initial therapy were 87.5% (1 year), 50% (2 years) and 34.3% (3 years). Among patients in clinical stages II and III, liver function tended to be aggravated following RTx, whereas patients in clinical stage I tended to remain in stage I. A Radiation dosage of 60 Gy is tolerable if patients in clinical stage I are selected and the gastrointestinal organs are excluded from the radiation field.