2227 - Outcomes Following Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma: A Single Institution Experience

03:00pm - 04:00pm ET

Poster Hall - Exhibit Hall A

Screen: 29

POSTER

Presenter(s)

Andrew Skipper, MD - Duke University Health System, Durham, NC

J. J. Qazi¹, D. Burner¹, R. Laoprasert¹, A. Skipper¹, D. Niedzwiecki², Z. Wan², S. J. Stephens¹, M. Palta¹, and C. Eyler¹; ¹Duke University Medical Center, Department of Radiation Oncology, Durham, NC, ²Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC

Purpose/Objective(s):

There is a growing body of evidence supporting the use of stereotactic body radiation therapy (SBRT) to treat hepatocellular carcinoma (HCC). Here we report a retrospective, single-institution experience treating HCC with SBRT.

Materials/Methods:

Patients completing an initial course of SBRT for HCC were retrospectively identified. Other prior liver directed therapy was allowed. Data was manually captured via chart review. SBRT dose and fractionation were chosen by the treating physicians. Time-to-event analyses were calculated from the SBRT start date. Overall survival (OS), freedom from local progression (FFLP) of the lesion treated with SBRT, freedom from out of radiation field liver progression (FFOFLP), and freedom from Child Pugh score increase of 2 or more (FFCP2) were estimated using the Kaplan-Meier method.

Results:

124 patients were included in the cohort. Median age at diagnosis was 67 years (IQR 61–74); 68.9% were male. Cirrhosis was present in 79.1%. ECOG performance status was 0–1 in 69.5% and 2–3 in 30.5%. Most patients had a single lesion (73.7%). Among patients with available Child-Pugh classification, 62.3% were Class A and 27.2% Class B. Median planning target volume among evaluable patients was 113.5 cc (IQR 53.8–240.9). SBRT dose and fractionation varied, ranging from 30-55Gy (median 50Gy), 3-10 fractions (median 5 fractions). Median OS was 22.1 months (95% CI 15.2–26.2) with 81 deaths observed. The 12- and 24-month OS were 70.4% and 44.1%, respectively. For FFLP analysis, median FFLP was not reached. The 12- and 24-month FFLP were 80.1% and 70.3%, respectively. Median FFOFLP was 14.1mo. The 6-, 12-, and 24-month FFOFLP were 73.1%, 54.8%, and 38.3%, respectively. Median FFCP2 was not reached. The 6-, 12-, and 24-month FFCP2 were 87.9%, 78.6%, and 74.7%, respectively.

Conclusion:

In this large, single-institution cohort of patients with HCC treated with SBRT, local tumor control was high and appeared durable. Liver function was preserved in the majority of patients. These findings support SBRT as an effective local therapy for HCC in a real-world population.