Radiotherapy for osseous metastases from hepatocellular carcinoma: a retrospective study of 57 patients.

Abstract

We undertook to evaluate the therapeutic effects of radiotherapy in patients with bone metastases from hepatocellular carcinoma (HCC), identify prognostic factors, and find an optimum radiation schedule. We retrospectively analyzed the clinical records of 57 patients (99 sites) with painful bone metastases from HCC from December 1978 to March 1997. Their ages ranged from 51 to 82 yr (mean, 62 yr), and the male:female ratio was 49:8. Among them, there were nine patients (16%) with metastases to other organs. Twenty patients (35%) had a solitary bone metastasis and 37 (65%) had multiple bone metastases. The total radiation dose ranged from 20 to 65 Gy (mean, 43 Gy) and that of the Time, Dose, and Fractionation Factor (TDF) values (per explanation given in text) ranged from 35.2 to 118.2 (mean, 73.2). Pain relief was obtained for 83.8% (83/99) of bone metastases from HCC. Those with a TDF value of > or = 77 (a TDF value of 77 is nearly equal to 48 Gy administered in fractions of 2 Gy each daily or 39 Gy administered in fractions of 3 Gy each daily), responded better than those with a TDF value of < 77 (p < 0.05). Overall, the median survival time from the start of radiotherapy was 179 days (6 months). Patients with a solitary bone metastasis and those without metastases to other organs had a better prognosis (p < 0.05 for both subgroups). Radiation therapy was effective for bone metastases from HCC, especially for those treated with a TDF value of > or = 77.