Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 31:12:1097-1110.
doi: 10.2147/JHC.S519770. eCollection 2025.

Effectiveness and Safety of Systemic Therapy and Stereotactic Body Radiotherapy in Oligoprogressive and Oligometastatic Hepatocellular Carcinoma

Zhuo Song #  1 , Xuan Zheng #  1 , Hongzhi Wang #  1 , Dezuo Dong  1 , Xianggao Zhu  1 , Jianhao Geng  1 , Shuai Li  1 , Maxiaowei Song  1 , Rongxu Du  1 , Yangzi Zhang  1 , Zhiyan Liu  1 , Yong Cai  1 , Yongheng Li  2 , Weihu Wang  1
Affiliations

Effectiveness and Safety of Systemic Therapy and Stereotactic Body Radiotherapy in Oligoprogressive and Oligometastatic Hepatocellular Carcinoma

Zhuo Song et al. J Hepatocell Carcinoma. .

Abstract

Purpose: This study explored the efficacy and safety of combining systemic therapy with stereotactic body radiotherapy (SBRT) for oligoprogressive (OP) and oligometastatic (OM) hepatocellular carcinoma (HCC).

Patients and methods: From January 2017 to June 2023, 37 HCC patients (28 OP, 9 OM) receiving systemic therapy and SBRT were identified. OP is defined as up to 5 progressive lesions with others stable after systemic therapy and OM as newly identified metastatic disease with up to 5 metastatic lesions. SBRT was delivered in fractions of 5 Gy or more to all lesions. Clinical outcomes and toxicity were evaluated.

Results: The median follow-up was 32.8 months. The objective response rates (ORRs) were 47.2%, 44.4%, and 55.5% for overall, OP, and OM cohorts. SBRT treated 48 OP and 17 OM lesions, achieving an ORR of 64.7%. For overall, OP, and OM cohorts, the 2-year local failure rates were 3.0%, 4.0%, and 0%, with median progression-free survival (PFS) of 11.2, 11.2, and 10.2 months, and median overall survival (OS) of 34.9 months, 32.6 months, and not reached (NR), respectively. In the OP cohort, 12 patients switched to next-line systemic therapy (OP-N) and 16 remained on current therapy (OP-C). Median PFS and OS were 11.6 months and NR for OP-N versus 16.5 months and 32.6 months for OP-C (P=0.89 and 0.47). Grade 3 acute and late treatment-related adverse events occurred in 40.5% and 5.4% of patients.

Conclusion: Systemic therapy combined with SBRT was effective and safe for OP and OM HCC. SBRT may delay next-line systemic therapy by blocking OP.

Keywords: efficacy; hepatocellular carcinoma; oligometastatic; oligoprogressive; safety; stereotactic body radiotherapy.

Plain language summary

Combining systemic therapy with stereotactic body radiotherapy (SBRT) represents a promising treatment strategy for oligoprogressive (OP) and oligometastatic (OM) hepatocellular carcinoma.This study demonstrates that SBRT combined with systemic therapy may offer favorable short-term response and long-term outcomes while maintaining a good safety profile.OP patients who continue their current systemic therapy while receiving SBRT may block OP status and achieve outcomes comparable to those who switch therapies, highlighting the potential of this approach to delay treatment changes and improve outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Waterfall plot of the best response in OP cohort (A) and OM cohort (B).
Figure 2
Figure 2
Cumulative local failure rates of overall (A), OP and OM cohorts (B); PFS of overall (C), OP and OM cohorts (D); OS of overall (E), OP and OM cohorts (F).
Figure 3
Figure 3
Waterfall plot of the best response in OP-N group (A) and OP-C group (B); PFS of OP-N and OP-C groups (C); OS of OP-N and OP-C groups (D).
None
See this image and copyright information in PMC

References

    1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–263. doi:10.3322/caac.21834 - DOI - PubMed
    1. Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent. 2024;4(1):47–53. doi:10.1016/j.jncc.2024.01.006 - DOI - PMC - PubMed
    1. Rumgay H, Ferlay J, De Martel C, et al. Global, regional and national burden of primary liver cancer by subtype. Eur J Cancer. 2022;161:108–118. doi:10.1016/j.ejca.2021.11.023 - DOI - PubMed
    1. Zhong J-H, Peng N-F, You X-M, et al. Tumor stage and primary treatment of hepatocellular carcinoma at a large tertiary hospital in China: a real-world study. Oncotarget. 2017;8(11):18296–18302. doi:10.18632/oncotarget.15433 - DOI - PMC - PubMed
    1. Guckenberger M, Lievens Y, Bouma AB, et al. Characterisation and classification of oligometastatic disease: a European society for radiotherapy and oncology and European organisation for research and treatment of cancer consensus recommendation. Lancet Oncol. 2020;21(1):e18–e28. doi:10.1016/S1470-2045(19)30718-1 - DOI - PubMed

LinkOut - more resources