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Improved oncologic outcomes by ablative radiotherapy in patients with bone metastasis from hepatocellular carcinoma

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

For bone metastasis from hepatocellular carcinoma (HCC), radiotherapy (RT) has been used a palliative treatment with little impact on survival. Currently, ablative RT is popularly used, and a more than palliative effect is expected. Herein, we investigated the clinical efficacy of ablative RT in patients with bone metastasis from HCC.

Methods

In total, 530 patients with 887 lesions treated in 1992–2019 were reviewed. Oligometastasis was defined as the presence of < 5 lesions. Total doses were normalized to obtain biologically effective doses (BEDs). The cut-off threshold of the BED was determined via receiver operating characteristics curve analysis. The Kaplan–Meier method was used to calculate overall survival (OS); propensity score matching (PSM) was performed to balance the heterogeneity in cases while comparing BEDs of ≥ 60 and < 60 Gy.

Results

The most common site of metastasis was the spine (59%); 59 patients (11%) presented with oligometastasis, and 76.2% of patients showed objective pain palliation after RT. Median OS was 5.1 months for all patients; patients with oligometastasis showed longer OS than those without (9.8 vs. 4.7 months). A Cox proportional hazards model showed that performance status, Child–Pugh class, extraosseous metastasis, primary HCC status, α-fetoprotein level, and radiation dose (BED) were significant prognostic factors. Post PSM, BED was the only treatment-related prognostic factor that remained significant; the median OS durations were 8.1 and 4.4 months when the BEDs were ≥ 60 and < 60 Gy, respectively.

Conclusion

Ablative RT improved OS and pain palliation in patients with bone metastasis from HCC.

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Data availability

This study is original and is not text-recycling.

Code availability

IBM SPSS, version 25.0 (IBM Corp., Armonk, NY).

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Acknowledgements

This study was supported by the Dong-A research fund (Grant Number: 2018-31-0904).

Author information

Author notes

  1. Sangjoon Park

    Present address: Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea

  2. Chai Hong Rim

    Present address: Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Korea

  3. Chiwhan Choi

    Present address: Department of Radiation Oncology, St. Carollo General Hospital, Suncheon, Korea

Authors and Affiliations

  1. Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea

    Tae Hyung Kim, Sangjoon Park, Chai Hong Rim, Chiwhan Choi & Jinsil Seong

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  1. Tae Hyung Kim
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  2. Sangjoon Park
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Contributions

This study was designed by THK and JS. SP, CHR, and CC contributed to the data collection and analysis. The manuscript was written by THK and JS, and commented on by all authors.

Corresponding author

Correspondence to Jinsil Seong.

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The authors declare that they have no competing interests.

Ethics approval and consent to participate

This study was approved by our Institutional Review Board (IRB #4-2020-0756).

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All authors agreed to publication.

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Kim, T.H., Park, S., Rim, C.H. et al. Improved oncologic outcomes by ablative radiotherapy in patients with bone metastasis from hepatocellular carcinoma. J Cancer Res Clin Oncol 147, 2693–2700 (2021). https://doi.org/10.1007/s00432-021-03553-2

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  • DOI: https://doi.org/10.1007/s00432-021-03553-2

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