PURPOSE: We sought to determine efficacy, safety, and outcome of stereotactic hypofractionated radiation therapy (SHORT) as a suitable bridging therapy for patients awaiting liver transplantation (LT) for hepatocellular carcinoma (HCC). We also examined histological response to radiation in the resected or explanted livers. METHODS AND MATERIALS: Between August 2007 and January 2009, 18 patients with 21 lesions received SHORT. A median total dose of 50 Gy was delivered in 10 fractions. Three patients underwent either chemoembolization (n = 1) or radiofrequency ablation (n = 2) prior to SHORT. Radiographic response was based on computed tomography evaluation at 3 months after SHORT. Histological response as a percentage of tumor necrosis was assessed by a quantitative morphometric method. RESULTS: Six of 18 patients were delisted because of progression (n = 3) or other causes (n = 3). Twelve patients successfully underwent major hepatic resection (n = 1) or LT (n = 11) at a median follow-up of 6.3 months (range, 0.6-11.6 months) after completion of SHORT. No patient developed gastrointestinal toxicity Grade ≥3 or radiation-induced liver disease. Ten patients with 11 lesions were evaluable for pathological response. Two lesions had 100% necrosis, three lesions had ≥50% necrosis, four lesions had ≤50% necrosis, and two lesions had no necrosis. All patients were alive after LT and/or major hepatic resection at a median follow-up of 19.6 months. CONCLUSIONS: SHORT is an effective bridging therapy for patients awaiting LT for HCC. It provides excellent in-field control with minimal side effects, helps to downsize or stabilize tumors prior to LT, and achieves good pathological response.
PURPOSE: We sought to determine efficacy, safety, and outcome of stereotactic hypofractionated radiation therapy (SHORT) as a suitable bridging therapy for patients awaiting liver transplantation (LT) for hepatocellular carcinoma (HCC). We also examined histological response to radiation in the resected or explanted livers. METHODS AND MATERIALS: Between August 2007 and January 2009, 18 patients with 21 lesions received SHORT. A median total dose of 50 Gy was delivered in 10 fractions. Three patients underwent either chemoembolization (n = 1) or radiofrequency ablation (n = 2) prior to SHORT. Radiographic response was based on computed tomography evaluation at 3 months after SHORT. Histological response as a percentage of tumor necrosis was assessed by a quantitative morphometric method. RESULTS: Six of 18 patients were delisted because of progression (n = 3) or other causes (n = 3). Twelve patients successfully underwent major hepatic resection (n = 1) or LT (n = 11) at a median follow-up of 6.3 months (range, 0.6-11.6 months) after completion of SHORT. No patient developed gastrointestinal toxicity Grade ≥3 or radiation-induced liver disease. Ten patients with 11 lesions were evaluable for pathological response. Two lesions had 100% necrosis, three lesions had ≥50% necrosis, four lesions had ≤50% necrosis, and two lesions had no necrosis. All patients were alive after LT and/or major hepatic resection at a median follow-up of 19.6 months. CONCLUSIONS: SHORT is an effective bridging therapy for patients awaiting LT for HCC. It provides excellent in-field control with minimal side effects, helps to downsize or stabilize tumors prior to LT, and achieves good pathological response.
Authors: Mishal Mendiratta-Lala; William Masch; Prasad R Shankar; Holly E Hartman; Matthew S Davenport; Matthew J Schipper; Chris Maurino; Kyle C Cuneo; Theodore S Lawrence; Dawn Owen Journal: Int J Radiat Oncol Biol Phys Date: 2018-09-10 Impact factor: 7.038
Authors: Maria-Aggeliki Kalogeridi; Anna Zygogianni; George Kyrgias; John Kouvaris; Sofia Chatziioannou; Nikolaos Kelekis; Vassilis Kouloulias Journal: World J Hepatol Date: 2015-01-27
Authors: D Bossé; T Ng; C Ahmad; A Alfakeeh; I Alruzug; J Biagi; J Brierley; P Chaudhury; S Cleary; B Colwell; C Cripps; L A Dawson; M Dorreen; E Ferland; P Galiatsatos; S Girard; S Gray; F Halwani; N Kopek; A Mahmud; G Martel; L Robillard; B Samson; M Seal; J Siddiqui; L Sideris; S Snow; M Thirwell; M Vickers; R Goodwin; R Goel; T Hsu; E Tsvetkova; B Ward; T Asmis Journal: Curr Oncol Date: 2016-12-21 Impact factor: 3.677
Authors: Lei Chen; Xiaopeng Guo; Shi Chen; Yanqiao Ren; Tao Sun; Fan Yang; Chuansheng Zheng Journal: Am J Transl Res Date: 2021-01-15 Impact factor: 4.060