Hepatic Reirradiation for Patients with Recurrent Hepatocellular Carcinoma

For treating hepatocellular carcinoma (HCC), local therapies and surgery, including liver transplant, are the first line treatment options; however, several contraindications limit their clinical use. The improvement of radiotherapy (RT) established RT in treating HCC contraindicated against local therapies, including transarterial chemoembolization and radiofrequency ablation. For HCC that recurs after RT and still contradicts against local therapies, there is a need to investigate the use of reirradiation. This study recruited patients receiving two courses of RT for recurrent HCC between January 2007 and December 2019. The result suggested that patients who experienced tumor regression after reirradiation had better survival over those with a stable form of the disease, with the mean overall survival (OS) as 30.0 and 4.0 months, respectively (p < 0.001). The analysis also revealed that systemic therapy had no benefit on both the OS and controlling distant metastasis; the result was limited to a small study number and diversity of drugs. Considering systemic therapy and portal vein tumor thrombosis, which are commonly viewed to affect prognosis, multivariate analysis suggested that the Child–Pugh score and local control were the only two independent factors for the OS, with p = 0.017 and p = 0.028, respectively. Our findings suggested that reirradiation could be the choice for treating recurrent HCC.