Outcomes of radiotherapy of hepatocellular carcinoma: a retrospective analysis

BACKGROUND: Technical advances and a better understanding of liver tolerance have changed the role of radiotherapy in the treatment of liver cancer. The goal of this retrospective study was to evaluate the outcomes of radiotherapy with curative intent in patients ineligible for surgery and palliative intent in patients with advanced disease. METHODS: Patients were treated with stereotactic body radiotherapy (SBRT), hypofractionated radiotherapy, or conventionally fractionated radiotherapy. Patients with a solitary liver tumor, no vascular invasion, Child-Pugh class A, and no extrahepatic tumors at the time of radiotherapy were considered for radiotherapy with curative intent, and the remaining patients for radiotherapy with palliative intent. Kaplan-Meier statistics and Cox proportional hazards regression analyses were used to evaluate overall survival. RESULTS: Between 04/2019 and 08/2022, 93 consecutive patients with hepatocellular carcinoma (HCC) were treated external beam radiotherapy in our department. A total of 94.6% of the patients had received prior treatment. The 1-, 2-, and 3-year overall survival rates of patients treated with curative intent (n = 33) were 100%, 76%, and 65%, respectively, and those treated with palliative intent (n = 60) 63%, 31%, and 11%, respectively. No acute radiation reactions of grade ≥ 3 (CTCAE v5.0) were observed. CONCLUSIONS: Our data confirm that radiotherapy is an effective treatment option with curative intent for selected patients ineligible for surgery, and with palliative intent for those with advanced disease.