the role of radical dose of radiotherapy in hepatocellular carcinoma

Background: the incidence of hepatocellular carcinoma has significantly increased over the last decades and the prognosis of hepatocellular carcinoma still remains poor. the present study aimed to evaluate the efficacy and safety of 3d conformal hypofractionated radiotherapy in patients with small hepatocellular carcinoma. method: between 2015 and 2018, a total of 61 patients presented to our institution with hepatocellular carcinoma ≤ 5cm, who were recruited in this prospective study. all the patients underwent 3d conformal hypofractionated radiotherapy with a total dose of 51 gy in 17 fractions. we evaluated the treatment response and toxicity and calculated the local progression-free survival and overall survival. results: the objective response rate was 68.9%, including seven patients (11.5%) achieving complete response and 35 patients (57.4%) with partial response. in addition, nine subjects (14.8%) had stable disease. the 1-, 2-, and 3-year overall survival rates were 65.1%, 38.7%, and 26.4%, respectively. in multivariate cox regression model, gtv was found to be the only prognostic factor for local control (p = 0.001) and overall survival (p < 0.001). only one patient showed grade 3 radiation-induced hepatic toxicity (1.6%). conclusion: 3d conformal hypofractionated radiotherapy could be effective and safe in small hepatocellular carcinoma.