Phase 2 trial of neoadjuvant intensity-modulated radiotherapy for centrally located hepatocellular carcinoma

Centrally located hepatocellular carcinoma (HCC) has unsatisfactory outcome when treated with surgery alone. A phase 2 trial at the Cancer Institute and Hospital of the Chinese Academy of Medical Sciences (Beijing) evaluated neoadjuvant intensity-modulated radiotherapy (IMRT) before surgery in patients with centrally located HCC. Radiotherapy-related grade 3 adverse events were observed in 7.9% of the patients, and there were no grade IIIb or higher operative complications. The median disease-free survival was 45.8 months, and the overall survival rate at 5 years was 69.1%. The authors conclude that neoadjuvant IMRT plus surgery is effective and well tolerated in patients with centrally located HCC.