Clinical Effects And Prognostic Factors Of Gyro Knife Radiotherapy In Patients With Hepatocellular Carcinoma

Purpose: We evaluated the short-term effects of cobalt-60 gyro rotating stereotactic radiotherapy (gyro knife) for primary hepatocellular carcinoma (HCC) ineligible for local therapy or surgery. Methods: Between August 2010 and December 2014, gyro knife radiotherapy was used in our department of radiation oncology to treat 63 patients with HCC who met the inclusion criteria and were unable or unwilling to undergo surgery. Patients were aged 58 years on average, and the mean radiation dose was 3614.84 cGy. The short-term effects, side effects, survival time, and prognostic factors were analyzed after treatment. Results: At follow-up 3 months after radiotherapy, there were 29 complete response patients, 23 partial response patients, nine stable disease patients, and two progressive disease patients, accounting for an overall response rate of 82.5%. The local control rate after a 1-year follow-up was 84.1%. There were no grade 4 hematologic, gastrointestinal, or hepatic toxicities. The half-year, 1-year, and 2-year survival rates of patients were 83.9% (51/63), 54.8% (30/63), and 20.2% (7/63), respectively, with a median survival time of 450 days (15 months). In the univariate analysis of the test group, survival was significantly associated with Eastern Cooperative Oncology Group (ECOG) score, longest tumor diameter, portal vein tumor thrombosis, total dose, Child-Pugh class of liver function, and AJCC stage (P<0.05). The multivariate analysis showed that ECOG (P = 0.012, Wald = 6.292) and Child-Pugh class of liver function (P = 0.000, Wald = 34.602) significantly correlated with overall survival. Conclusions: Our study suggests that gyro knife treatment is a very safe and effective treatment option for HCC patients.