Gastrointestinal Cancer

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SU_15_2148 - Hepatocellular Carcinoma: Patterns of Care and Outcomes for Patients receiving Stereotactic Radiation Therapy

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Hepatocellular Carcinoma: Patterns of Care and Outcomes for Patients receiving Stereotactic Radiation Therapy
N. Sheth1, V. W. Osborn2, P. Adedoyin1, J. Safdieh Jr3, and D. P. Schreiber4; 1SUNY Downstate Medical Center, Brooklyn, NY, 2Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, 3Department of Radiation Oncology, Kings County Hospital Center, Brooklyn, NY, 4Front Range Radiation Oncology PC, Littleton, CO

Purpose/Objective(s): This study aims to analyze the patterns of care, including fractionation and utilization, of hypofractionated stereotactic body radiotherapy (SBRT) in the treatment of hepatic cellular carcinoma

Materials/Methods: The NCDB was queried for patients diagnosed with hepatocellular carcinoma (HCC) in 2004-2014 and treated with radiotherapy in 3, 4, or 5 fractions in 15-20, 10-13, or 6-12Gy per fraction respectively. Patients with stage IV and Charlson-Deyo Comorbidity Index > 0 were excluded in order to avoid bias resulting from selection of poorer prognosis patients. The patients were then stratified based on several characteristics including Biologically Equivalent Doses (BEDs) of > 100 Gy and <100 Gy to determine whether there was an association with overall survival (OS) benefit and a multivariable analysis (MVA) was performed to assess for potential confounding factors.

Results: There were 462 patients identified in whom the most common SBRT fractionation regimen was 10Gy x 5 fractions (25.3%), followed by 8Gy x 5 (17.7%), and 15-16Gy x 3 (26.4%). 152 patients were treated to a BED < 100Gy which was associated with a median overall survival (OS) of 20.8 months (95% CI 14.551-27.109. 310 patients were treated to a BED > 100Gy which was associated with a median overall survival (OS) of 30.8 months (95% CI 5.251-32.083. On MVA, BED > 100Gy was not significant associated with improved OS (HR 0.852 CI 0.638-1.137, p=0.277). Factors that were associated with significantly worse survival were tumor size in the largest quartile (HR 2.197 CI 1.440-3.354, p<0.0001) and T3a disease (HR 2.474 CI 1.472-4.158, p=0.001 compared to T1).

Conclusion: The most common SBRT fractionation regimen was 10Gy x 5 fractions. BED dose ≥ 100Gy was not associated with a significant survival benefit. However, local control data are not available within the NCDB.

Author Disclosure: N. Sheth: None. V.W. Osborn: None. J. Safdieh: None. D.P. Schreiber: None.

Niki Sheth, MD, BS

Downstate Medical Center

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