External beam radiotherapy to treat intra- and extra-hepatic dissemination of hepatocellular carcinoma after radiofrequency thermal ablation

J Gastroenterol Hepatol. 2006 Oct;21(10):1555-60. doi: 10.1111/j.1440-1746.2006.04432.x.

Abstract

Background: Radiofrequency ablation (RFA) is an alternative to percutaneous ethanol injection therapy (PEIT) for single non-surgical hepatocellular carcinoma. However, the risk of seeding along the needle track has been reported.

Methods: Seven patients presenting with neoplastic seeding after RFA or PEIT were treated with external beam radiotherapy using conventional fractionation. All patients underwent irradiation with a total dose in the range of 44-61 Gy (median and mode value: 50 Gy).

Results: An objective response to treatment was achieved in six of seven patients (86%). A complete response was obtained in two patients (29%). The median survival time was 14.7 months and the actuarial 1- and 2-year survivals were 67% and 50%, respectively.

Conclusions: The response to treatment was relatively good without serious complications. Seeding from hepatocellular carcinoma is sensitive to external beam radiotherapy. It is useful in the treatment of these patients with 50 Gy in 25 fractions.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / radiotherapy*
  • Carcinoma, Hepatocellular / surgery
  • Catheter Ablation*
  • Dose Fractionation, Radiation
  • Dose-Response Relationship, Radiation
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms / pathology
  • Liver Neoplasms / radiotherapy*
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Invasiveness*
  • Postoperative Care / methods
  • Retrospective Studies
  • Treatment Outcome