Stereotactic radiosurgery using cyberknife for the patients with primary hepatocellular carcinoma

Background: Radiotherapy, as a therapeutic option, has a limited role for the treatment of HCC, but, cyberknife is a newly developed hypofractionated stereotactic body radiation therapy (SBRT). The objective of this retrospective study was to evaluate the efficacy of cyberknife compared with conventional radiotherapy for the patients with advanced HCC. Methods: We retrospectively reviewed the medical records of patients with HCC who were treated with cyberknife and conventional radiotherapy from January 2007 to March 2011 at Konyang University Hospital. A total of 114 patients were analyzed: receiving cyberknife (n=77) and receiving conventional radiotherapy (n=37). These two groups were compared according to various clinical features. Results: 77 patients with HCC were treated with cyberknife and 37 patients were treated with conventional radiotherapy. Among the two groups, there were no significant differences in age, sex, tumor stage (modified UICC), MELD score, and previous treatment modalities (eg. TACE, RFA and operation). (p=0.184/.931/.073/.701/.162). But, significant differences in ECOG, Child class between two groups (p=<0.001 and .032). Overall actual survival at 3 years was 14.29% (11/77) and 16.23% (6/37) and no significant differences between two groups(p=0.091) (ITT analysis). Conclusions: Cyberknife and conventional radiotherapy for HCC has no significant differences in survival despite of better ECOG and Child class in the cyberknife group. Further studies are needed to define the role of cyberknife in the management of primary HCC.