1Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Korea
4Research Institute and Hospital, National Cancer Center, Goyang, Korea
5Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea
6Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
7Department of Radiation Oncology, Korea University Ansan Hospital, Ansan, Korea
8Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
9Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
10Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Korea
11Department of Radiation Oncology, Dong-A University College of Medicine, Busan, Korea
12Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
13Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
14Department of Biostatistics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Copyright © 2017 by the Korean Cancer Association
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Characteristic | No. (%) (n=765) |
---|---|
Age, median (range, yr) | 57 (24-86) |
Sex | |
Male | 641 (83.8) |
Female | 124 (16.2) |
Viral type | |
B | 596 (77.9) |
C | 69 (9.0) |
B & C | 5 (0.7) |
NBNC | 86 (11.2) |
Other | 9 (1.2) |
ECOG | |
0-1 | 714 (93.3) |
2-3 | 51 (6.7) |
C-P class | |
A | 615 (80.4) |
B | 128 (16.7) |
C | 14 (1.8) |
Unknown | 8 (1.0) |
Pre-RT treatment | |
No | 312 (40.8) |
Yes | 453 (59.2) |
mUICC stage | |
I | 29 (3.8) |
II | 111 (14.5) |
III | 287 (37.5) |
IV | 338 (44.2) |
Tumor sizea), median (range, cm) | 6.5 (0-20.0) |
No. of tumors | |
Single | 315 (41.3) |
Multiplicity | 448 (58.7) |
PVT | |
No | 389 (50.8) |
Yes | 376 (49.2) |
LN metastasis | |
No | 667 (87.2) |
Yes | 98 (12.8) |
Pre-RT tumor marker | |
AFP, median (range, IU/mL) | 95.3 (0.3-2,922,754.0) |
PIVKA-II, median (range, mAU/mL) | 283.5 (7.0-176,595.0) |
NBNC, non-B non-C; ECOG, Eastern Cooperative Oncology Group; C-P, Child-Pugh; RT, radiotherapy; mUICC, modified International Union for Cancer Control; PVT, portal vein thrombosis; LN, lymph node; AFP, alphafetoprotein; PIVKA-II, protein induced by vitamin K absence-II.
a) Tumor size: intrahepatic tumor size based on modified Response Evaluation Criteria in Solid Tumors Criteria.
Characteristic | No. (%) (n=765) |
---|---|
Age, median (range, yr) | 57 (24-86) |
Sex | |
Male | 641 (83.8) |
Female | 124 (16.2) |
Viral type | |
B | 596 (77.9) |
C | 69 (9.0) |
B & C | 5 (0.7) |
NBNC | 86 (11.2) |
Other | 9 (1.2) |
ECOG | |
0-1 | 714 (93.3) |
2-3 | 51 (6.7) |
C-P class | |
A | 615 (80.4) |
B | 128 (16.7) |
C | 14 (1.8) |
Unknown | 8 (1.0) |
Pre-RT treatment | |
No | 312 (40.8) |
Yes | 453 (59.2) |
mUICC stage | |
I | 29 (3.8) |
II | 111 (14.5) |
III | 287 (37.5) |
IV | 338 (44.2) |
Tumor size |
6.5 (0-20.0) |
No. of tumors | |
Single | 315 (41.3) |
Multiplicity | 448 (58.7) |
PVT | |
No | 389 (50.8) |
Yes | 376 (49.2) |
LN metastasis | |
No | 667 (87.2) |
Yes | 98 (12.8) |
Pre-RT tumor marker | |
AFP, median (range, IU/mL) | 95.3 (0.3-2,922,754.0) |
PIVKA-II, median (range, mAU/mL) | 283.5 (7.0-176,595.0) |
Characteristic | No. (%) (n=765) |
---|---|
Treatment volume | |
Tumor | 272 (35.6) |
Tumor+PVT | 347 (45.4) |
Tumor+LN | 12 (1.6) |
Tumor+PVT+LN | 14 (1.8) |
PVT | 63 (8.2) |
PVT+LN | 18 (2.4) |
LN | 39 (5.1) |
RT technique | |
3D CRT | 565 (73.9) |
IMRT | 138 (18.0) |
SBRT | 62 (8.1) |
Completion of planned RT | |
No | 32 (4.2) |
Yes | 733 (95.8) |
Combination treatment | |
No | 299 (39.1) |
Yes | 466 (60.9) |
Radiation dose, median (range, Gy) | |
All patients (n=765) | |
Fractional dose | 2.5 (1.8-20.0) |
Total dose | 45.0 (3.0-72.0) |
BED (Gy10) | 56.3 (3.9-180.0) |
3D CRT (n=565) | |
Fractional dose | 2.5 (1.8-6.0) |
Total dose | 45.0 (3.0-72.0) |
BED (Gy10) | 53.1 (3.9-96.0) |
IMRT (n=138) | |
Fractional dose | 2.5 (1.8-6.0) |
Total dose | 50.0 (30.0-72.0) |
BED (Gy10) | 68.8 (39.0-96.0) |
SBRT (n=62) | |
Fractional dose | 13.8 (5.0-20.0) |
Total dose | 45.0 (25.0-60.0) |
BED (Gy10) | 112.5 (37.5-180.0) |
Variable | Univariate |
Multivariate |
||||
---|---|---|---|---|---|---|
Exp (B) | 95% CI | p-value | Exp (B) | 95% CI | p-value | |
Overall survival | ||||||
Age | 0.994 | 0.986-1.003 | 0.181 | - | - | - |
Sex | 0.924 | 0.726-1.175 | < 0.001 | - | - | - |
ECOG | 3.679 | 2.707-5.001 | < 0.001 | 3.064 | 2.208-4.251 | < 0.001 |
C-P class | 3.371 | 2.752-4.129 | < 0.001 | 2.651 | 2.120-3.316 | < 0.001 |
Tumor size | 1.089 | 1.067-1.111 | < 0.001 | 1.057 | 1.032-1.083 | < 0.001 |
No. of tumors | 1.466 | 1.261-1.705 | < 0.001 | 1.264 | 1.051-1.521 | < 0.001 |
LN metastasis | 2.255 | 1.779-2.858 | < 0.001 | 1.746 | 1.332-2.291 | < 0.001 |
PVT | 1.931 | 1.613-2.310 | < 0.001 | 1.337 | 1.077-1.658 | < 0.001 |
Stage | 1.822 | 1.613-2.058 | < 0.001 | 1.320 | 1.114-1.564 | 0.001 |
Pre-RT AFP | 1.000 | 1.000-1.000 | < 0.001 | - | - | - |
Pre-RT treatment | 0.825 | 0.690-0.990 | < 0.001 | 1.390 | 1.132-1.707 | 0.002 |
BED | 0.984 | 0.979-0.990 | < 0.001 | - | - | - |
RT technique | 0.456 | 0.314-0.660 | < 0.001 | - | - | - |
Combination treatment | 1.105 | 0.922-1.324 | < 0.280 | - | - | - |
Infield failure-free survival | ||||||
Age | 0.998 | 0.986-1.010 | 0.697 | - | - | - |
Sex | 0.927 | 0.655-1.313 | 0.670 | - | - | - |
ECOG | 1.813 | 1.034-3.179 | 0.038 | - | - | - |
C-P class | 1.740 | 1.237-2.447 | 0.001 | 1.590 | 1.115-2.267 | 0.010 |
Tumor size | 1.027 | 0.996-1.060 | 0.088 | - | - | - |
No. of tumors | 1.057 | 0.850-1.314 | 0.620 | 0.706 | 0.545-0.914 | 0.008 |
LN metastasis | 1.804 | 1.262-2.579 | 0.001 | - | - | - |
PVT | 1.894 | 1.462-2.454 | < 0.001 | 1.295 | 0.972-1.726 | 0.077 |
Stage | 1.748 | 1.468-2.082 | < 0.001 | 1.652 | 1.326-2.060 | < 0.001 |
Pre-RT AFP | 1.000 | 1.000-1.000 | < 0.639 | - | - | - |
Pre-RT treatment | 1.078 | 0.827-1.405 | 0.577 | 1.670 | 1.258-2.216 | < 0.001 |
BED | 0.977 | 0.969-0.986 | < 0.001 | 0.986 | 0.977-0.995 | < 0.003 |
RT technique | 0.416 | 0.237-0.729 | 0.002 | - | - | - |
Combination treatment | 1.134 | 0.870-1.477 | 0.352 | - | - | - |
Outfield failure-free survival | ||||||
Age | 0.988 | 0.980-0.996 | 0.002 | 0.991 | 0.983-0.999 | 0.036 |
Sex | 0.920 | 0.735-1.153 | 0.470 | - | - | - |
ECOG | 2.167 | 1.512-3.106 | < 0.001 | 1.791 | 1.222-2.625 | 0.003 |
C-P class | 1.735 | 1.388-2.168 | < 0.001 | 1.510 | 1.184-1.925 | 0.001 |
Tumor size | 1.046 | 1.025-1.067 | < 0.001 | 1.035 | 1.010-1.061 | 0.007 |
No. of tumors | 1.349 | 1.171-1.555 | < 0.001 | 1.185 | 0.996-1.409 | 0.055 |
LN metastasis | 1.418 | 1.104-1.821 | < 0.001 | - | - | - |
PVT | 1.470 | 1.241-1.740 | < 0.001 | 1.229 | 1.002-1.507 | 0.048 |
Stage | 1.359 | 1.223-1.509 | < 0.001 | 1.142 | 0.985-1.325 | 0.078 |
Pre-RT AFP | 1.000 | 1.000-1.000 | < 0.001 | - | - | - |
Pre-RT treatment | 1.086 | 0.914-1.290 | 0.348 | 1.349 | 1.075-1.692 | 0.010 |
BED | 0.990 | 0.986-0.995 | < 0.001 | 0.995 | 0.989-1.000 | 0.053 |
RT technique | 0.653 | 0.478-0.892 | 0.007 | - | - | - |
Combination treatment | 0.923 | 0.778-1.095 | 0.360 | 0.796 | 0.637-0.993 | 0.044 |
Characteristic | Stage I (n=29) | Stage II (n=111) | Stage III (n=287) | Stage IV (n=338) | p-value |
---|---|---|---|---|---|
RT technique | |||||
3D CRT | 13 (44.8) | 61 (55.0) | 228 (79.4) | 263 (77.8) | < 0.001 |
IMRT | 1 (3.4) | 24 (21.6) | 43 (15.0) | 70 (20.7) | |
SBRT | 15 (51.7) | 26 (23.4) | 16 (5.6) | 5 (1.5) | |
Fractional dose (Gy) | 7.0 (2.0-19.0) | 3.5 (1.8-20.0) | 2.5 (1.8-20.0) | 2.5 (1.8-13.0) | < 0.001 |
BED (Gy10) | 79.2 (42.9-165.3) | 65.3 (37.5-180.0) | 56.0 (3.9-180.0) | 53.1 (14.4-119.6) | < 0.001 |
Completion of planned RT | |||||
No | 0 | 1 (0.9) | 7 (2.4) | 24 (7.1) | 0.005 |
Yes | 29 (100) | 110 (99.1) | 280 (97.6) | 314 (92.9) | |
Combination treatment | |||||
No | 26 (89.7) | 71 (64.0) | 98 (34.1) | 104 (30.8) | < 0.001 |
Yes | 3 (10.3) | 40 (36.0) | 189 (65.9) | 234 (69.2) |
NBNC, non-B non-C; ECOG, Eastern Cooperative Oncology Group; C-P, Child-Pugh; RT, radiotherapy; mUICC, modified International Union for Cancer Control; PVT, portal vein thrombosis; LN, lymph node; AFP, alphafetoprotein; PIVKA-II, protein induced by vitamin K absence-II. Tumor size: intrahepatic tumor size based on modified Response Evaluation Criteria in Solid Tumors Criteria.
PVT, portal vein thrombosis; LN, lymph node; RT, radiotherapy; 3D CRT, 3-dimensional conformal radiotherapy; IMRT, intensity-modulated radiotherapy; SBRT, stereotactic body radiotherapy; BED, biological effective dose.
CI, confidence interval; ECOG, Eastern Cooperative Oncology Group; C-P, Child-Pugh; LN, lymph node; PVT, portal vein thrombosis; RT, radiotherapy; AFP, α-fetoprotein; BED, biological effective dose.
Values are presented as number (%) or median (range). RT, radiotherapy; 3D CRT, 3-dimensional conformal radiotherapy; IMRT, intensity-modulated radiotherapy; SBRT, stereotactic body radiotherapy; BED, biological effective dose.