Therapeutic Effect And Prognostic Factors Of Hypofractionated Three-dimensional Conformal Radiotherapy For Recurrent Hepatocellular Carcinoma

Objective To investigate the effect of hypofractionated three-dimensional conformal radiotherapy(3DCRT)on the survival and prognosis of recurrent hepatocellular carcinoma(HCC).Methods The data of 46 recurrent HCC patients were treated by hypofractionated 3DCRT using 8 MV X-ray.The median gross target volume (GTV)was 480cm~3(17～2312cm~3).Patients received a total dose of 44～60 Gy (mean 52.5 Gy),4～8 Gy/time,3 times/week.Results Immediately response rates were CR 10.9%,PR 56.5%,NC 21.7%,PD 10.9%,respectively.The(CR+PR)response rate was 67.4%.The 1-,2-,3- year survival rates were 60.3%,43.4%and 27.4%respectively, median survival time 18 months(from 2 months to 85 months).In the lesions complicated with portal vein tumor thrombosis(PVTT),the(CR+PR)response rate was 73.7%,the 1-,2-,3- year survival rates were 42.1%,26.3%and 21.1%respectively.The incidence of radiation-induced liver disease(RILD) was 10.9%,and the incidence of radiation-induced upper gastrointestinal tract breeding was 4.3%.The number of lesions,category of recurrence and GTV were independent prognostic factors when analyzed by Cox propotional hazards model.Conclusions It is effective to treat unresectable recurrent HCC with hypofractionated 3DCRT by improving the local control and the survival,and is also effective for lesions complicated with PVTT,and the side effects are mild and tolerable.The number of lesions,category of recurrence and GTV were identified as the predictors for recurrent HCC patients.