J Cancer 2019; 10(17):4031-4037. doi:10.7150/jca.28674 This issue

Research Paper

A randomized trial of conventional fraction versus hypofraction radiotherapy for bone metastases from hepatocellular carcinoma

Jian He, Shiming Shi, Luxi Ye, Guifen Ma, Xiangou Pan, Yan Huang, Zhaochong Zeng

Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

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Citation:
He J, Shi S, Ye L, Ma G, Pan X, Huang Y, Zeng Z. A randomized trial of conventional fraction versus hypofraction radiotherapy for bone metastases from hepatocellular carcinoma. J Cancer 2019; 10(17):4031-4037. doi:10.7150/jca.28674. Available from https://www.jcancer.org/v10p4031.htm

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Abstract

External beam radiotherapy (EBRT) has been reported to be effective in palliating painful bone metastases, but the optimal fractions and doses for treating bone metastases from hepatocelluar carcinoma (HCC) are not established. This study aimed to compare toxicity and efficacy for conventional fraction versus hypofraction schedules. From January 2009 through December 2014, 183 patients with HCC bone metastases were randomly assigned to conventional fraction EBRT (Group A) or hypofraction radiotherapy (Group B). Study outcomes were pain relief, response rate and duration, overall survival, and toxicity incidence. Median follow-up time was 9.3 months. Response times were 6.7 ± 3.3 fractions in Group A and 4.1 ± 1.2 fractions in Group B (p <0.001). Pain relief rates were 96.7% and 91.2% in Group A and B, respectively (p=0.116). Time to treatment failure for Group A was significantly longer than Group B (p=0.025). Median overall survival was similar between two groups (p=0.628). Toxicity incidence in both groups was minimal, with no significant differences observed.

In conclusion, hypofractionated radiotherapy is safe for patients with HCC bone metastases and may achieve earlier pain relief compared to conventional radiotherapy. This protocol should be considered for patients with shorter predicted survival times.

Keywords: hepatocellular carcinoma, external beam radiotherapy, conventional fractionation, hypofractionated, toxicity