Conformal radiotherapy as a bridge to liver transplantation for hepatocellular carcinoma: is it safe?

ABSTRACT

AIM: To report a preliminary experience of conformal radiotherapy (CRT) as bridge to orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC). METHODS: Data of 12 patients undergoing CRT for HCC followed by OLT between 2012 and 2014 were reviewed. RESULTS: CRT was used in a neoadjuvant or downstaging setting in nine and three patients, respectively. No radiation-related systemic toxicity was observed. Median blood loss and operating time were 1450 ml (600-4000) and 420 min (240-510), respectively. Four patients had diaphragmatic injury. Complete histological response was observed in six patients, and partial response in five. Seven patients developed severe postoperative morbidity including five anastomosis-related complications and one death. CONCLUSION: CRT for HCC provides satisfactory histological response but may compromise OLT safety.