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. 2015 Jan;9(1):94-102.
doi: 10.5009/gnl14009.

Predictive factors of palliative radiotherapy response and survival in patients with spinal metastases from hepatocellular carcinoma

Chihwan Choi  1 , Jinsil Seong  1
Affiliations

Predictive factors of palliative radiotherapy response and survival in patients with spinal metastases from hepatocellular carcinoma

Chihwan Choi et al. Gut Liver. 2015 Jan.

Abstract

Background/aims: Spinal metastases often severely limit the quality of life by causing severe pain and neurological deficits. The purpose of this study was to evaluate the palliative effect of radiotherapy (RT) for spinal metastases from hepatocellular carcinoma (HCC) and to identify factors predictive of survival in HCC patients with spinal metastases who received RT.

Methods: A retrospective analysis was performed on 192 patients with spinal metastases from HCC who received RT.

Results: Of 192 patients with spinal metastases from HCC, an overall pain response to palliative RT occurred in 187 patients (97.4%), with a complete pain response (CR) in 41 patients (21.4%) and a partial response in 151 patients (78.6%). A higher biologically effective dose (BED) and more advanced RT techniques were identified as predictive factors for a CR. The 1- and 2-year overall survival (OS) rates were 18.1% and 6.3%, respectively, and the median survival time was 4.5 months. A long OS was associated with good performance status, controlled primary HCC, absence of extrahepatic metastases, and a higher BED.

Conclusions: RT provided effective palliation for patients with painful spinal metastases from HCC. Our results provide information regarding pain control, survival outcomes, and predictive factors for the prognosis of HCC patients with spinal metastases treated with RT.

Keywords: Carcinoma, hepatocellular; Pain response; Predictive factors; Radiotherapy; Spinal metastases.

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Figures

Fig. 1
Fig. 1
Stratified cumulative survival curves according to risk factor group. Risk factors were poor performance status (Eastern Cooperative Oncology Group 3–4), uncontrolled primary hepatocellular carcinoma, and the presence of extrahepatic metastases. Group A, 0 risk factors; group B, 1 risk factor; group C, 2 risk factors; group D, 3 risk factors. p-values were determined using the log-rank test.
Fig. 2
Fig. 2
Stratified cumulative survival curves according to biologically effective dose. p-values were determined using the log-rank test.
See this image and copyright information in PMC

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