Outcomes of 5 versus 10 Fraction Radiation Therapy for Hepatocellular Carcinoma at a Veteran Affairs Hospital.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 42069261.
- Also identified by DOI 10.1016/j.ijrobp.2026.04.081.
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Abstract
To compare outcomes, liver toxicity, and survival between patients with hepatocellular carcinoma (HCC) treated with stereotactic body radiation therapy (SBRT) delivered in 5 versus 10 fractions within a Veterans Affairs population. A retrospective review was performed of patients with unresectable or medically inoperable HCC treated with SBRT at the XXX Veterans Affairs Medical Center between 2013 and 2024. Patients treated with palliative intent or lacking follow-up were excluded. The standard regimen was 50 Gy in 5 fractions; 50 Gy in 10 fractions was used when organ-at-risk constraints precluded 5-fraction delivery. Demographic, clinical, and dosimetric data were extracted from the Veterans Affairs National Corporate Data Warehouse. Outcomes were analyzed using Kaplan-Meier and Cox proportional hazards models. Among 147 patients (median age 67 years), 96 received 50 Gy in 5 fractions and 51 received 50 Gy in 10 fractions. Most patients had cirrhosis (93.9%) and Child-Pugh class A liver function (82.3%). Tumors were larger in the 10-fraction cohort (median 35 cc vs 14 cc, p.