1. T7-005
Survival and Prognostic Factors for Patients with Advanced Hepatocellular Carcinoma after Stereotactic Ablative Radiotherapy
Wen-Yen Huang (黃文彥), Cheng-Hsiang Lo, Jen-Fu Yang,
Ming-Yueh Liu, Yee-Min Jen, Chun-Shu Lin, Hsing-Lung Chao
Department of Radiation Oncology
Tri-Service General Hospital

2. Disclosure of conflict of interest: none

3. Radiotherapy in Liver Tumors
RT was not standard treatment for liver cancer.
Limitation:
* poor radiation tolerance of normal liver
* organ motion

8. SABR for liver cancer in TSGH
Research overview
1. Indications (safety and efficacy)
(1) Recurrent HCC (Int J Radiat Oncol Biol Phys 2012)
(2) TACE-failed HCC (European Journal of Gastroenterology & Hepatology 2014)
(3) Re-irradiation for HCC (Journal of Gastroenterology and Hepatology 2014)
2. Identify prognostic indicators
(1) 18F-FDG PET parameters (J Nucl Med 2013)
3. Image response evaluation
(1) Radiographic response evaluation for PVTT (Therapeut Radiol Oncol 2016)
(2) Functional image biomarker (DWI) (Ongoing)
4. Other than HCC
(1) SABR for Cholangiocarcinoma (2017 Tumori, Epub)
5. Development and validation of nomogram for treatment outcome
(1) For BCLC stage C disease (International study under ALRT SIG)
6. Immunological biomarkers before and after SABR
(1) Tim-3, PD1, PD L1 (ongoing)

10. Purpose
To evaluate the survival outcomes and prognostic factors for patients with BCLC stage C HCC after SABR.

11. Materials & Methods A retrospective cohort study
Between December 2007 and July 2015
BCLC stage C disease
Child-Turcotte-Pugh class A–B

14. Results 110 patients with 148 tumors
1-year in-field control rate: 76.9%
3-year in-field control rate: 66.4%
1-year OS: 49.6%
3-year OS: 23.6%

15. Median survival:
≥2, 1, and 0 predictors:
5.8, 22.7, and 26.4 months (p < 0.001)

16. External validation
NTUH
35 cases
BCLC stage C
Child A/B

17. External validation TSGH NTUH 110 cases 35 cases BCLC stage C
Child A/B
Median survival:
≥2, 1, and 0 predictors:
5.8, 22.7, and 26.4 months (p < 0.001)
NTUH
35 cases
BCLC stage C
Child A/B
Median survival:
≥2, 1, and 0 predictors:
2.7, 9.6, and 24.8 months (p < 0.02)

18. Future work
Asia Pacific Primary Liver Cancer Expert Meeting (APPLE) Asia liver radiation therapy special interest group international study
Title: Development and validation of a nomogram for Treatment Outcome of Patients with BCLC stage C HCC after SABR: an international study in Asia

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