Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality. Stereotactic body radiotherapy (SBRT) is a promising alternative for inoperable patients or those not eligible for other locoregional therapies.
Aim: To characterize patients with HCC treated with SBRT at the Clínica IRAM (Chile) and to evaluate imaging responses at 3 months. Secondarily, we aim to analyze overall survival (OS) and treatment toxicity. Materials / Methods: This retrospective study included patients treated with SBRT between June 2016 and September 2022. Patients were not candidates for other locoregional therapies. Clinical and demographic characteristics, imaging responses based on mRECIST and LIRADS-TRA (v.2018) criteria, overall survival (OS), and treatment toxicity were recorded.
Results: A total of 63 treatments were performed on 57 patients (median age: 68.6 years). The median tumor size was 5.5 cm (range: 0.95-13 cm), with 89% of cases classified as Barcelona Clinic Liver Cancer B-C stages. The imaging response rate at 3 months was 93% (39.5% complete and 46.5% partial). The 12-month OS rate was 65.2% (95% CI: 50.9-76.6), with a median survival of 10.8 months. Tumor size was significantly associated with worse OS (HR 3.4; p <0.01). Toxicity was manageable, with grade ≥3 events in 9.1% of patients.
Conclusion: SBRT is a safe and effective option with high tumor response rates, even in patients with intermediate and advanced HCC stages. This study underscores the importance of a multidisciplinary approach and supports the inclusion of SBRT as a real integral treatment option in HCC.