Cyberknife Radiosurgery in Hepatocellular Carcinoma.

Objective: To determine the outcome of Stereotactic Body Radiation Therapy (SBRT) and its prognostic factors among hepatocellular carcinoma (HCC) patients.
Study Design: Descriptive study.
Place and Duration of Study: Department of Radiology and Cyberknife Robotic Radiosurgery, Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan from 1st July 2019 to 31st August 2020.
Methodology: All patients of either gender age 18 years and above presenting with pathological confirmation of HCC, ECOG performance status of ≤2 and child Pugh A or B were consecutively enrolled. Progression of >20% was defined as progressive disease (PD). SBRT was performed using the Cyberknife. Clinical outcome was measured in terms of progression free survival. Moreover, radiation induced toxicity was also observed along with other predictor variables.            Results: Of 52 patients, the median age was 58 (53-59) years. There were 42 (80.8%) males and 10 (19.2%) females. All patients were alive at 3 months, i.e. 52 (100%). However, at 6 months, 49 (94.2%) were alive, at 9 months, 38 (73.1%) patients were alive while at 1 year, 24 (46.2%) patients were alive. A significant association was observed for survival at 6 months and ECOG performance status score (p-value 0.036), survival at 9 months and AFP (p= 0.003), survival at 1 year and age (p = 0.019), survival at 1 year and HBV (p = 0.001), and survival at 1 year and previous treatment (p = 0.010). Moreover, none of the patients reported complications / radiation induced liver toxicity.
Conclusion: A higher efficiency of SBRT was found among HCC patients attending Radiology Department. Key Words: Stereotactic body radiation therapy, Hepatocellular carcinoma, Toxicity, Survival.