Radiotherapy for 65 patients with advanced unresectable hepatocellular carcinoma

Table 1 Baseline characteristics of the 65 patients who underwent radiotherapy for unresectable hepatocellular carcinoma

Characteristics	Number of patients (%)
Age (yr)	60 (42-83)1
< 60/≥ 60	35 (53.8)/30 (46.2)
Gender (Male/Female)	56 (86.2)/9 (13.8)
Underlying liver disease (viral/alcohol)	52 (80.0)/13 (20.0)
Liver cirrhosis	50 (76.9)
Ascites	24 (36.9)
Child-Pugh class (A/B)	43 (66.2)/22 (33.8)
Albumin (g/dL)2	3.4 ± 0.5
Bilirubin (mg/dL)2	1.2 ± 0.9
Alkaline phosphatase (IU/L)2	151.8 ± 79.3
Platelet (103/mL)2	156.3 ± 66.2
Prothrombin time (INR)2	1.2 ± 0.2
Sodium (mEq/L)2	137.7 ± 3.7
Creatinine (mg/dL)2	1.0 ± 0.9
Tumor size (cm)2	10.8 ± 4.7
< 10/≥ 10	34 (52.3)/31 (47.7)
Tumor type (SN/MN/massive)	3 (4.6)/24 (36.9)/38 (58.5)
Portal vein thrombosis	45 (69.2)
UICC stage (III/IV-A)	12 (18.5)/53 (81.5)
α-fetoprotein (IU/mL)2	17 454 ± 66 005
> 400/ ≤ 400	28 (43.1)/37 (56.9)
Radiotherapy aim (primary/salvage)	40 (61.5)/25 (38.5)

¹Median (range);

²mean ± SD; INR: International normalized ratio; SN: Single nodular; MN: Multinodular.

Table 2 Baseline characteristics of the 65 patients, according to treatment response

	Pts without OTR (n = 28)	Pts with OTR (n = 37)	P value
Age (yr)	61 ± 10	58 ± 8	0.271
Gender (M:F)	22:6	34:3	0.124
Hepatitis B	21 (75%)	28 (75.7%)	0.950
Hepatitis C	2 (7.1%)	1 (2.7%)	0.573
Alcohol abuse	5 (17.9%)	8 (21.6%)	0.707
WBC (/mm3)	5450 ± 1671	6079 ± 2229	0.216
Hemoglobin (g/dL)	11.4 ± 2.2	12.0 ± 1.8	0.207
Platelet (× 103/mm3)	160 ± 73	154 ± 608	0.733
AST (IU/L)	111 ± 93	71 ± 53	0.032
ALT (IU/L)	62 ± 51	69 ± 90	0.686
ALP (IU/L)	175 ± 89	134 ± 67	0.038
Bilirubin (mg/dL)	1.47 ± 1.27	0.91 ± 0.49	0.035
Albumin (g/dL)	3.3 ± 0.4	3.5 ± 0.5	0.103
Prothrombin time, INR	1.16 ± 0.22	1.15 ± 0.14	0.796
Creatinine (mg/dL)	1.17 ± 1.31	0.92 ± 0.25	0.329
Liver cirrhosis	21 (75%)	29 (78.4%)	0.749
Child-Pugh grade A	14 (50%)	31 (83.8%)	0.003
Alpha-fetoprotein (ng/dL)	31 474 ± 98 160	6844 ± 15 814	0.199
≥ 400 ng/dL	15 (53.6%)	22 (59.5%)	0.635
Tumor size (mm)	118 ± 37	99 ± 52	0.112
≥ 10 cm	18 (64.3%)	14 (37.8%)	0.035
Multiple tumor	24 (85.7%)	30 (81.1%)	0.622
Massive type	18 (64.3%)	20 (54.1%)	0.407
Main portal vein thrombosis	10 (35.7%)	10 (27%)	0.452
Tumor stage IV	23 (82.1%)	30 (81.1%)	0.913

OTR: Objective treatment response; WBC: White blood cell; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; INR: International normalized ratio; Tumor stage: According to the TNM staging system of Liver Cancer Study Group of Japan.

Table 3 Multivariate analysis of the mortality of patients who underwent radiotherapy for advanced hepatocellular carcinoma

		P value	β	Odd ratio	95% CI
Tumor size	0 ≤ 10 cm;	0.012	0.954	2.597	1.232-5.473
	1 ≥ 10 cm
Child-Pugh grade	0 = Grade A;	0.001	1.336	3.802	1.687-8.568
	1 = Grade B
Combined with TACE	0 = Yes;	0.001	1.671	5.315	2.015-14.018
	1 = No
Objective treatment response	0 = Yes;	0.006	1.194	3.300	1.414-7.699
	1 = No

Table 4 Adverse events in the 65 patients who underwent radiotherapy for unresectable hepatocellular carcinoma n (%)

	Grade
	0	1	2	3	4	5
Hematologic	14 (21.5)	33 (50.8)	12 (18.5)	5 (7.7)	1 (1.5)	-
Hepatic	32 (49.2)	20 (30.8)	8 (12.3)	4 (6.2)	1 (1.5)	-
GI hemorrhage			1 (1.5)	2 (3.1)		2 (3.1)