Online

ESTRO 2020

Session Item

Poster highlights 5 CL : GI
8040
Poster Highlights
Clinical
14:47 - 14:55
Update of mono-institutional retrospective cohort of 200 patients affected by HCC treated with SBRT
Jacopo Di Muzio, Italy
PH-0160

Abstract

Update of mono-institutional retrospective cohort of 200 patients affected by HCC treated with SBRT
Authors: Roberta Carlevato.(Radiation Oncology- University of Turin, Department of Oncology, Torino, Italy), Jacopo Di Muzio.(Radiation Oncology- A.O.U. "Città della Salute e della Scienza di Torino", Department of Oncology, Torino, Italy), Pierfrancesco Franco.(Radiation Oncology- University of Turin, Department of Oncology, Torino, Italy), Alessia Silvia Guarneri.(Radiation Oncology- A.O.U. "Città della Salute e della Scienza di Torino", Department of Oncology, Torino, Italy), Riccardo Ragona.(Radiation Oncology- University of Turin, Department of Oncology, Torino, Italy), Ricardi Umberto.(Radiation Oncology- University of Turin, Department of Oncology, Torino, Italy)
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Purpose or Objective

Standard treatment of hepatocellular carcinoma (HCC) is surgery and liver transplantation. RadioFrequency Ablation (RFA), TransArterial ChemoEmbolization (TACE) are used as alternative.  Stereotactic Body Radation Therapy (SBRT) is a new oncological and technological approach.  Aim of the study is to evaluate the clinical results of stereotactic body radiation therapy in the treatment of hepatocellular carcinoma (HCC) in patients unsuitable or failing to standard loco-regional therapies.

Material and Methods

We retrospectively reviewed a cohort of two-hundred patients with 291 HCC lesions treated with a SBRT at a single Institution between September 2012 and April 2019. SBRT treatment reckon on a prescription dose between 36-48 Gy in 3-5 fractions at the isodose of 80%. Primary endpoint included in-field (LC) local control and toxicity. Secondary endpoints were overall (OS), cancer-specific (CSS) and progression-free survival (PFS). Acute toxicity was scored with CTCAE 4.3 and tumor response with mRECIST parameter. Characteristics of the patients are shown in Table 1. 

Results

Median follow-up was 20 months (range 1-77). 169 (84,5%) patients had a Child-Pugh class A, 28 (14%) a class B, in 3 (1,5%) patients Child-Pugh class was non evaluable. Median lesion size was 25 mm (range 10-120).188 (62,5%) lesions were located in the right liver, 85 (31,2%) in the left liver and 18 (6,2%) in the first segment. 89 (44,5%) lesion were treated with SBRT only while 111 (55,5%) were relapses. During follow-up 167 lesions (57,3%) had a complete response, 57 (19,5%)  had a partial response, 35 (12%) were stable and 15 (5,1%) radiological progression. Twenty-eight patients (14%) went to liver transplantation. LC at 12, 24 and 36 months was 99,5%, 98,3% and 98,3% respectively. OS at 12, 24 and 36 months was 79,9%, 63,6% and 53,5% respectively. Till the end of follow-up ninety-two patients (46%) died. CSS at 12, 24 and 36 months was 86,8%,74,1% and 67,6% respectively. PFS at 12, 24 and 36 months was 58,1%, 48,3% and 42,7% respectively.  Fifteen patients (7,5%) experienced extra-hepatic failure.15 patients (9%) experienced G3-G4 acute toxicity at the blood chemistry test and 1 patients died for liver failure. Taking into account a  Delta-Child score > 2 twelve cases of  non-classic Radiation-Induced Liver Disease (RILD) were reported. 

Conclusion

SBRT is a safe , effective and well tolerated treatment for patients with naïve or recurrent HCC but needs an appropriate selection of the lesions to be treated, an adequate technological equipment and an experienced staff.