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Radiotherapy effective for spinal metastases from HCC

Radiotherapy was effective in palliation for treating spinal metastases from hepatocellular carcinoma, according to study data from a retrospective analysis.

Researchers analyzed data from 192 patients with HCC who underwent palliative radiotherapy at Severance Hospital in Seoul, South Korea, between April 1992 and February 2012. The goal was to determine any factors that predicted survival in these patients after palliative radiotherapy. The median follow-up was 4.2 months.

“Radiotherapy can provide significant palliation of painful bone metastases in approximately 60% to 90% of patients, with up to 33% of patients achieving complete pain response at the irradiated site,” the researchers wrote. “At our institute, [radiotherapy] has been actively adopted in the management of bone metastases from HCC, particularly for those causing pain.”

An overall pain response to palliative radiotherapy was observed in 97.4% of all patients (n = 187). Of these patients, 41 had a complete pain response and 151 patients had a partial pain response.

In univariate analysis, a higher biologically effective dose (BED; P < .001) and advanced radiotherapy techniques (P = .002) were found to be predictive factors for a complete pain response. In multivariate analysis, a higher BED (P = .003) and advanced radiotherapy technique (P = .009) also were predictive factors for a complete pain response.

The 1-year overall survival rate was greater compared with 2-year survival rate (18.1% vs. 6.3%), with a median survival of 4.5 months. A greater OS was associated with good performance status (P < .001), controlled primary HCC (P < .001), absence of extrahepatic metastases (P = .012) and a higher BED (P < .001), according to the research.

“In the present study, we determined whether pain relief could be predicted using tumor characteristics and treatment modalities of spinal metastases from HCC,” the researchers wrote. “Hence, all patients with painful spinal metastases from HCC, regardless of spinal assessment criteria in imaging studies, including presence of mass-type metastases, pathologic fracture and spinal cord compression, may obtain similar benefits from [radiotherapy].”

Disclosure: The researchers report no relevant financial relationships.