Post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma

Kyung Su Kim, Kyubo Kim, Eui Kyu Chie, Yoon Jun Kim, Jung Hwan Yoon, Hyo Suk Lee, Sung W. Ha

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5 Scopus citations


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.

Original languageEnglish
Pages (from-to)36-41
Number of pages6
JournalRadiation Oncology Journal
Issue number1
StatePublished - 2015

Bibliographical note

Publisher Copyright:
© 2015, The Korean Society for Radiation Oncology.


  • Brain metastases
  • Hepatocellular carcinoma
  • Intracranial hemorrhages


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