OBJECTIVE. To evaluate the efficacy and toxicities of stereotactic radiotherapy for unresectable hepatocellular carcinoma.

DESIGN. Retrospective study.

SETTING. Prince of Wales Hospital, Hong Kong.

MAIN OUTCOME MEASURES. Treatment outcome and toxicities.

PATIENTS. During the period of 2000 to 2004, 16 patients with hepatocellular carcinoma treated with stereotactic radiotherapy were reviewed.

RESULTS. Of the 16 patients, 11 had assessable responses. For local control, there were two complete and three partial responses, five with stable disease and one with progressive disease, giving a local response rate of 45% and control rate of 91%. The median survival was 23 months. The 1-year and 3-year overall survival rates were 62% and 28%, respectively. The most frequent site of recurrence was intrahepatic but outside the irradiated field. Two patients with Child-Pugh B cirrhosis developed radiation-induced liver disease. No other grade 3/4 toxicities were recorded.

CONCLUSION. Stereotactic radiotherapy gives high local control rates and has the potential to prolong survival in patients with hepatocellular carcinoma. It is safe and tolerable in Child-Pugh A patients.

Key words: Carcinoma, hepatocellular; Chemoembolization, therapeutic; Liver neoplasms; Radiotherapy, conformal; Survival analysis

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