Clinical effect of Cyber Knife stereotactic radiosurgery in treatment of patients with small hepatocellular carcinoma

Objective To investigate the clinical effect and safety of Cyber Knife stereotactic radiosurgery in the treatment of small hepatocellular carcinoma ( s HCC) . Methods Twenty-eight patients with s HCC who underwent Cyber Knife radiosurgery in 302 hospital of PLA form March 2011 to December 2012 were enrolled. The total dose of Cyber Knife radiosurgery was 35-60 Gy in 3-5 fractions for 3-6 consecutive days. The median follow-up was 36 months. Modified Response Evaluation Criteria in Solid Tumors was used as assessment indices for short-term therapeutic effect, and the 1-, 2-, and 3-year overall survival rates and local control rates were used as assessment indices for long-term therapeutic effect. The Kaplan-Meier method was used to calculate cumulative survival rate and local control rate. Results Among the 28 patients, 17 achieved complete remission ( CR) , 8 achieved partial remission ( PR) , 2 achieved a stable disease, and1 had a progressive disease, resulting in a short-term response rate ( CR + PR) of 89. 28%. The 1-, 2-, and 3-year survival rates were 92. 86%, 85. 71%, and 78. 57%, respectively, and the 1-, 2-, and 3-year local control rates were 96. 43%, 92. 86%, and89. 28%, respectively. Toxic reactions were mainly grade 1 and 2 events. Conclusion Cyber Knife is a safe and effective option for s HCC and has the features of high local control rate, high survival rate, and few toxic reactions. Therefore, it can be used as an alternative treatment for patients with inoperable s HCC.