BACKGROUND: Since 2005, we have treated hepatocellular carcinoma (HCC) with stereotactic body radiotherapy (SBRT) uniformly at two dose levels, according to baseline liver function and normal liver dose. We retrospectively examined the outcomes for these patients. MATERIAL AND METHODS: Between 2005 and 2012, 221 HCC patients were treated with SBRT. Eligibility criteria for SBRT included a single (either solitary or recurrent) HCC lesion; unfeasible, difficult or refusal to undergo other surgery or percutaneous ablative therapies; Child-Pugh Classification (CPC) A or B; tumors ≤ 5 cm; dose to the bowels < 25 Gy/5 fractions; curative intent. Patients followed up ≥ 6 months were eligible. The prescribed dose depended on liver function and liver dose: 40 Gy for CPC-A and 35 Gy for CPC-B, in 5 fractions, requiring a 5-Gy dose reduction if the proportion of the liver receiving ≥ 20 Gy exceeded 20%. Treatment outcomes and safety were analyzed. RESULTS: A total of 185 patients (n = 48 in the 35-Gy group; n = 137 in the 40-Gy group) were eligible, with a median follow-up duration of 24 months (range 3-80). The three-year local control and overall survival rates were 91% and 70%, respectively. There were no significant differences in outcomes between dose levels: the three-year local control and overall survival rates in the 35-Gy and 40-Gy groups were 91% and 89% (log-rank p = 0.99) and 66% and 72% (p = 0.54), respectively. Acute toxicities ≥ grade 3 were observed in 24 (13.0%) patients, and 19 (10.3%) patients had worsening of CPC score by two points. All but three (1.6%) patients promptly recovered to grade 1-2. Grade 5 liver failure occurred in two patients in the 35-Gy group. CONCLUSION: SBRT for HCC was safe and provided equivalent outcomes when administered either in 35 or 40 Gy/5 fractions.
BACKGROUND: Since 2005, we have treated hepatocellular carcinoma (HCC) with stereotactic body radiotherapy (SBRT) uniformly at two dose levels, according to baseline liver function and normal liver dose. We retrospectively examined the outcomes for these patients. MATERIAL AND METHODS: Between 2005 and 2012, 221 HCC patients were treated with SBRT. Eligibility criteria for SBRT included a single (either solitary or recurrent) HCC lesion; unfeasible, difficult or refusal to undergo other surgery or percutaneous ablative therapies; Child-Pugh Classification (CPC) A or B; tumors ≤ 5 cm; dose to the bowels < 25 Gy/5 fractions; curative intent. Patients followed up ≥ 6 months were eligible. The prescribed dose depended on liver function and liver dose: 40 Gy for CPC-A and 35 Gy for CPC-B, in 5 fractions, requiring a 5-Gy dose reduction if the proportion of the liver receiving ≥ 20 Gy exceeded 20%. Treatment outcomes and safety were analyzed. RESULTS: A total of 185 patients (n = 48 in the 35-Gy group; n = 137 in the 40-Gy group) were eligible, with a median follow-up duration of 24 months (range 3-80). The three-year local control and overall survival rates were 91% and 70%, respectively. There were no significant differences in outcomes between dose levels: the three-year local control and overall survival rates in the 35-Gy and 40-Gy groups were 91% and 89% (log-rank p = 0.99) and 66% and 72% (p = 0.54), respectively. Acute toxicities ≥ grade 3 were observed in 24 (13.0%) patients, and 19 (10.3%) patients had worsening of CPC score by two points. All but three (1.6%) patients promptly recovered to grade 1-2. Grade 5 liver failure occurred in two patients in the 35-Gy group. CONCLUSION: SBRT for HCC was safe and provided equivalent outcomes when administered either in 35 or 40 Gy/5 fractions.
Authors: Sun Hyun Bae; Mi-Sook Kim; Won Il Jang; Chul-Seung Kay; Woochul Kim; Eun Seog Kim; Jin Ho Kim; Jin Hee Kim; Kwang Mo Yang; Kyu Chan Lee; A Ram Chang; Sunmi Jo Journal: Jpn J Clin Oncol Date: 2016-01-29 Impact factor: 3.019
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: 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: Ashwathy Susan Mathew; Eshetu G Atenafu; Dawn Owen; Chris Maurino; Anthony Brade; James Brierley; Robert Dinniwell; John Kim; Charles Cho; Jolie Ringash; Rebecca Wong; Kyle Cuneo; Mary Feng; Theodore S Lawrence; Laura A Dawson Journal: Eur J Cancer Date: 2020-05-24 Impact factor: 9.162