Korean J Hepatol.  2002 Sep;8(3):304-311.

Radiation Therapy for Bone Metastasis from Hepatocellular Carcinoma

• Koom WS
• Seong JS
• Lee MJ
• Park HC
• Han KH
• Chon JY
• Moon YM
• Suh CO

Abstract

BACKGROUND/AIM: Recent advances in both diagnosis and treatment have markedly improved the prognosis in patients with hepatocellular carcinoma (HCC). Bone metastasis has become a clinical problem in the treatment of HCC patients. The purpose of this study was to evaluate the palliative effect of radiotherapy for painful bone metastasis from HCC. METHODS: From January 1991 to June 2000, 51 patients (77 sites) with painful bone metastasis from HCC were retrospectively analyzed. Ages ranged from 21 to 80 years (median 55 years). The male:female ratio was 7.5:1. Synchronous or metachronous bone metastasis was seen in 20 (39%) and 31 patients (61%), respectively. The most common symptom of bone metastasis was pain (45 patients, 88%). Twenty-one patients (41%) had a solitary bone metastasis while 30 (59%) had multiple ones. The sites of bone metastasis, in order of frequency, were the vertebra (38), rib (20), and pelvis (19). The total radiation dose ranged from 12.5 to 50 Gy (median 30 Gy). The Wisconsin Brief Pain Questionnaire was used to evaluate pain response. RESULTS: The overall 1 and 2 year survival rates from the time of bone metastasis were 15% and 4%, respectively. The median survival time was 5 months. Intrahepatic stage(p=0.014), and metastasis to other organs(p=0.019) were significant prognostic factor for survival by univariate analysis. There was, however, no independent prognostic factor on multivariate analysis. Pain relief after radiotherapy was achieved for 56 sites (73%). CONCLUSION: The expected life span (median 5 months) in this group of patients suggests a strong necessity for effective treatment for symptomatic palliation. Radiation therapy was effective in pain palliation for bone metastasis from HCC, and this could improve patients' quality of life.

Keyword

Radiotherapy; Bone metastasis; Neoplasim/Liver/Hepatocellular carcinoma

MeSH Terms

Adult
Aged
Aged, 80 and over
Bone Neoplasms/*radiotherapy/*secondary
Carcinoma, Hepatocellular/mortality/*radiotherapy/*secondary
English Abstract
Female
Human
Liver Neoplasms/mortality/*pathology
Male
Middle Aged
Palliative Care
Retrospective Studies
Survival Rate