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Clinical & Experimental Metastasis

, Volume 29, Issue 3, pp 197–205 | Cite as

Palliative radiation therapy for pulmonary metastases from hepatocellular carcinoma

  • Wei Jiang
  • Zhao-Chong Zeng
  • Jian-Ying Zhang
  • Jia Fan
  • Meng-Su Zeng
  • Jian Zhou
Research Paper

Abstract

Although the lung is the most common site of extrahepatic metastases from hepatocellular carcinoma (HCC), the optimal treatment for such metastases has’nt been established. External beam radiotherapy (EBRT) is becoming a useful local control therapy for lung cancer. To evaluated the efficacy of EBRT treatment for such metastases, we retrospectively studied 13 patients (11 men and 2 women; mean age, 52.6 years) with symptomatic pulmonary metastases from HCC who had been treated with EBRT in our institution. The palliative radiation dose delivered to the lung lesions ranged from 47 to 60 Gy (median 50) in conventional fractions, while the intrahepatic lesions were treated with surgery or transarterial chemoembolization, and/or EBRT. Follow-up period from radiotherapy ranged from 3.7 to 49.1 months (median, 16.7). Among the 13 patients, 23 out of a total of 31 pulmonary metastatic lesions received EBRT. In 12/13(92.3%) patients, significant symptoms were completely or partially relieved. An objective response was observed in 10/13(76.9%) of the subjects by computed tomography imaging. The median progression-free survival for all patients was 13.4 months. The 2-year survival rate from pulmonary metastasis was 70.7%. Adverse effects were mild and consisted of bone marrow suppression in three patients and pleural effusion in one patient (all CTCAE Grade II). In conclusion, EBRT with ≤60 Gy appears to be a good palliative therapy with reasonable safety for patients with pulmonary metastases from HCC. However, large-scale randomized clinical trials will be necessary to confirm the therapeutic role of this method.

Keywords

Radiation therapy Hepatocellular carcinoma Lung metastases Outcome 

Abbreviations

HCC

Hepatocellular carcinoma

EBRT

External beam radiotherapy

CT

Computed tomography

BACE

Bronchial arterial chemoembolization

AFP

α-Fetoprotein

CEA

Carcinoembryonic antigen

CA19-9

Carbohydrate antigen 19-9

PmFI

Pulmonary metastases-free interval

TACE

Transarterial chemoembolization

3D-CRT

Three-dimensional conformal radiation therapy

GTV

Gross tumor volume

CTV

Clinical target volume

PTV

Planning target volume

DVH

Dose–volume histogram

OARs

Organs at risk

BED

Biologic effective dose

RECIST

Response evaluation criteria in solid tumors

CR

Complete response

PR

Partial response

SD

Stable disease

PD

Progression of disease

CTCAE

Common terminology criteria for adverse events

PFS

Progression-free survival time

CI

Confidence interval

WBC

Whiter blood cell counts

Notes

Acknowledgments

Funding

None.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Wei Jiang
    • 1
  • Zhao-Chong Zeng
    • 1
  • Jian-Ying Zhang
    • 1
  • Jia Fan
    • 2
  • Meng-Su Zeng
    • 3
  • Jian Zhou
    • 2
  1. 1.Department of Radiation OncologyZhongshan Hospital, Fudan UniversityShanghaiChina
  2. 2.Liver Cancer InstituteZhongshan Hospital, Fudan UniversityShanghaiChina
  3. 3.Department of RadiologyZhongshan Hospital, Fudan UniversityShanghaiChina

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