2812 - Prospective Quality of Life Outcomes after Stereotactic Body Radiotherapy for Hepatocellular Carcinoma in a Latin American Cohort

Purpose/Objective(s): to prospectively evaluate quality of life (QoL) in a cohort of patients with hepatocellular carcinoma (HCC) after treatment with stereotactic body radiotherapy (SBRT).

Materials/Methods: patients with HCC were enrolled in a prospective study of liver SBRT for patients with HCC that was not amenable to other locoregional therapies. Patients received 27.5-50 Gy of risk-adapted, 5-fraction image-guided SBRT. Prospective assessment of health-related quality of life (HRQoL) was conducted with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core-30 (QLQ-C30), the HCC-specific module (HCC18), and the EuroQoL 5 Dimension questionnaires at baseline and 1, 3, 6, 9, and 12 months after treatment. Primary endpoint was change in QLQ-C30 Global Health Status from baseline to 3 months; secondary endpoints included EQ-5D and QLQ-HCC18 over 12 months. Longitudinal changes were analyzed using linear mixed-effects models (LMM) with patient-level random intercepts to account for missing data and repeated measures.

Results: A total of 59 patients were included (73% male, 27% female; mean age 69.4 ± 9.2 years). All patients had liver cirrhosis, and the cause of liver disease was metabolic dysfunction-associated steatotic liver disease (MASLD) in 45 patients, MetALD in 3 patients, alcohol-related in 2 patients, and others in 9 patients. Overall survival at 1 year was 87%. Baseline QoL surveys were completed by 50 patients, with follow-up completion rates of 80% at 3 months, 56% at 6 months, and 22% at 12 months. The QLQ-C30 Global Index remained relatively stable during early follow-up (baseline: 49.4 vs. 3m: 49.4). The EQ-5D VAS remained stable throughout the study (?=0.524), with a score of 63.3 at baseline vs. 62.6 at 3 months. Finally, the liver-specific symptom burden measured by the QLQ-HCC18 Summary Score did not reach global significance (?=0.223), with scores of 12.9 at baseline vs. 14.2 at 3 months (table 1).

Conclusion: This is the first prospective assessment of quality of life in patients with HCC treated with SBRT in Latin America. In this cohort, predominantly with MASLD-related HCC, liver SBRT did not deteriorate overall HRQoL at 3 months post-treatment. Longitudinal analysis confirmed that liver SBRT is a well-tolerated therapy that preserves general health status throughout the first year of follow-up.