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Canadian Journal of Gastroenterology and Hepatology
Volume 2017, Article ID 6267981, 8 pages
Research Article

Exploration of Superior Modality: Safety and Efficacy of Hypofractioned Image-Guided Intensity Modulated Radiation Therapy in Patients with Unresectable but Confined Intrahepatic Hepatocellular Carcinoma

Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China

Correspondence should be addressed to Zhao-Chong Zeng; nc.hs.latipsoh-sz@gnohcoahz.gnez

Received 24 May 2017; Revised 10 August 2017; Accepted 17 September 2017; Published 1 October 2017

Academic Editor: Michele Molinari

Copyright © 2017 Tao Jiang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To evaluate the efficacy and safety of hypofractioned image-guided intensity modulated radiation therapy (IG-IMRT) for unresectable but confined intrahepatic hepatocellular carcinoma in comparison with conventional 3-dimensional conformal radiotherapy (3D-CRT). Methods. Ninety patients with unresectable but confined intrahepatic hepatocellular carcinoma without distant metastasis and tumor thrombosis received external beam radiation therapy. Of these patients, 45 received IG-IMRT and 45 received 3D-CRT. The IG-IMRT design delivered a median total hypofractionated dose of 54 Gy (2.2–5.5 Gy/fx), and 3D-CRT delivered a median total dose of 54 Gy with a conventional fraction (2.0 Gy/fx). The clinical response, overall survival, and side effects were analyzed. Results. The IG-IMRT group showed significantly higher 1-year survival (93.3 versus 77.8%) and 2-year survival (73.3 versus 51.1%) and longer median survival (44.7 versus 24.0 months) than the 3D-CRT group. Multivariate analysis indicated that the patients with intrahepatic tumors smaller than 8 cm, prior TACE before RT, and IG-IMRT would have a survival benefit. There were no significant differences in the rates of side effects between the two groups. Conclusion. Hypofractioned IG-IMRT could improve the therapeutic response and confer a potential survival of patients with unresectable but confined intrahepatic hepatocellular carcinoma compared to 3D-CRT with acceptable toxicity.