RADIOTHERAPY FOR OSSEOUS METASTASES FROM HEPATOCELLULAR-CARCINOMA - ARETROSPECTIVE STUDY OF 57 PATIENTS

Objective: We undertook to evaluate the therapeutic effects of radioth erapy in patients with bone metastases from hepatocellular carcinoma ( HCC), identify prognostic factors, and find an optimum radiation sched ule. Methods: We retrospectively analyzed the clinical records of 57 p atients (99 sites) with painful bone metastases from HCC from December 1978 to March 1997, Their ages ranged from 51 to 82 yr (mean, 62 yr), and the male:female ratio was 49:8, Among them, there were nine patie nts (16%) with metastases to other organs. Twenty patients (35%) had a solitary bone metastasis and 37 (65%) had multiple bone metastases. T he total radiation dose ranged from 20 to 65 Gy (mean, 43 Gy) and that of the Time, Dose, and Fractionation Factor (TDF) values (per explana tion given in text) ranged from 35.2 to 118.2 (mean, 73.2). Results: P ain relief was obtained for 83.8% (83/99) of bone metastases from HCC. Those with a TDF value of greater than or equal to 77 (a TDF value of 77 is nearly equal to 48 Gy administered in fractions of 2 Gy each da ily or 39 Gy administered in fractions of 3 Gy each daily), responded better than those with a TDF value of < 77 (p < 0.05). Overall, the me dian survival time from the start of radiotherapy was 179 days (6 mont hs). Patients with a solitary bone metastasis and those without metast ases to other organs had a better prognosis (p < 0.05 for both subgrou ps). Conclusions: Radiation therapy was effective for bone metastases from HCC, especially for those treated with a TDF value of greater tha n or equal to 77. (C) 1998 by Am. Cell. of Gastroenterology.