Post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma.

Abstract

PURPOSE:

To evaluate the incidence and risk factors of post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma (HCC).

MATERIALS AND METHODS:

Medical records of 81 patients who have been diagnosed of brain metastases from HCC and underwent surgery, radiosurgery and/or whole brain radiotherapy (WBRT) between January 2000 and December 2013 were retrospectively reviewed.

RESULTS:

Intracranial hemorrhage was present in 64 patients (79%) at the time of diagnosis. Median value of alpha-fetoprotein (AFP) level was 1,700 ng/mL. The Eastern Cooperative Oncology Group (ECOG) performance status for 20 patients was greater than 2. Fifty-seven patients underwent WBRT and the others were treated with surgery and/or radiosurgery without WBRT. During follow-up, 12 events of intracranial hemorrhage after treatment were identified. Three-month post-treatment hemorrhage rate was 16.1%. Multivariate analyses revealed that ECOG performance status, AFP, and WBRT were associated with post-treatment hemorrhage (p = 0.013, 0.013, and 0.003, respectively). Kaplan-Meier analysis showed that 3-month post-treatment hemorrhage rate of new lesion was higher in patients treated without WBRT, although statistical significance was not reached. (18.6% vs. 4.6%; p = 0.104). Ten of 12 patients with post-treatment hemorrhage died with neurologic cause.

CONCLUSION:

WBRT should be considered to prevent post-treatment hemorrhage in the treatment of brain metastases from HCC.

• Authors: Kyung Su Kim, Kyubo Kim, Eui Kyu Chie, Yoon Jun Kim, Jung Hwan Yoon, Hyo-Suk Lee, Sung W Ha
• Journal: Radiation oncology journal (Radiat Oncol J) Vol. 33 Issue 1 Pg. 36-41 (Mar 2015) ISSN: 2234-1900 [Print] Korea (South)
• PMID: 25874176 (Publication Type: Journal Article)