Outcomes of Stereotactic Body Radiotherapy for Hepatocellular Carcinoma with Severe Cirrhosis and Ineligibility for Transplant.

BACKGROUND/AIM:Our study reviewed the results of patients with hepatocellular carcinoma and Child-Pugh score 8-11 cirrhosis treated with stereotactic body radiotherapy when liver transplant was not an option. PATIENTS AND METHODS:A retrospective review was performed on 15 patients with Child-Pugh class B and C cirrhosis treated with stereotactic body radiotherapy. The median total dose was 35 Gy in 4-5 fractions. None were listed for a liver transplant due to either being outside of the Milan criteria or to medical contraindications. RESULTS:The overall survival was 26.7% at 6 months, with a mean survival of 152 days. The mean survival with and without ascites was 3.3 months and 8.3 months, respectively. CONCLUSION:For hepatocellular carcinoma with cirrhosis of Child-Pugh score 8 or more, prognosis after liver stereotactic body radiotherapy was suboptimal. While irradiation achieved local tumor control, progressive cirrhosis was a common cause of death. Patients without ascites at the time of radiotherapy had the best prognosis.