Ashley A Weiner1, Jeffrey Olsen2, Daniel Ma3, Pawel Dyk4, Todd DeWees1, Robert J Myerson1, Parag Parikh5. 1. Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA. 2. Department of Radiation Oncology, University of Colorado School of Medicine, Colorado Springs, CO, USA. 3. Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA. 4. Missouri Baptist Medical Center, St. Louis, MO, USA. 5. Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA. Electronic address: pparikh@radonc.wustl.edu.
Abstract
BACKGROUND AND PURPOSE: To report outcomes and toxicities of a single-institution phase I/II study of stereotactic body radiotherapy (SBRT) in the treatment of unresectable hepatocellular cancer (HCC) and intrahepatic cholangiocarcinoma (IHC). MATERIALS AND METHODS: Patients with Child-Pugh score less than 8 were eligible. A total of 32 lesions in 26 patients were treated with SBRT. Kaplan-Meier survival analysis was performed. Toxicities were graded by CTCAEv4 criteria and response was scored by EASL guidelines. RESULTS: Median prescribed dose was 55Gy (range 40-55Gy) delivered in 5 fractions. Mean tumor diameter was 5.0cm and mean GTV was 107cc. Median follow-up was 8.8months with a median survival of 11.1months, and one-year overall survival was 45%. Overall response rate was 42% and one-year local control was 91%. Nine patients experienced a decline in Child-Pugh class following treatment, and two grade 5 hepatic failure toxicities occurred during study follow-up. CONCLUSIONS: Primary hepatic malignancies not amenable to surgical resection portend a poor prognosis, despite available treatment options. Though radiation-induced liver disease (RILD) is rare following SBRT, this study demonstrates a risk of hepatic failure despite adherence to protocol constraints.
BACKGROUND AND PURPOSE: To report outcomes and toxicities of a single-institution phase I/II study of stereotactic body radiotherapy (SBRT) in the treatment of unresectable hepatocellular cancer (HCC) and intrahepatic cholangiocarcinoma (IHC). MATERIALS AND METHODS:Patients with Child-Pugh score less than 8 were eligible. A total of 32 lesions in 26 patients were treated with SBRT. Kaplan-Meier survival analysis was performed. Toxicities were graded by CTCAEv4 criteria and response was scored by EASL guidelines. RESULTS: Median prescribed dose was 55Gy (range 40-55Gy) delivered in 5 fractions. Mean tumor diameter was 5.0cm and mean GTV was 107cc. Median follow-up was 8.8months with a median survival of 11.1months, and one-year overall survival was 45%. Overall response rate was 42% and one-year local control was 91%. Nine patients experienced a decline in Child-Pugh class following treatment, and two grade 5 hepatic failure toxicities occurred during study follow-up. CONCLUSIONS:Primary hepatic malignancies not amenable to surgical resection portend a poor prognosis, despite available treatment options. Though radiation-induced liver disease (RILD) is rare following SBRT, this study demonstrates a risk of hepatic failure despite adherence to protocol constraints.
Authors: Shaelyn Culleton; Haiyan Jiang; Carol R Haddad; John Kim; Jim Brierley; Anthony Brade; Jolie Ringash; Laura A Dawson Journal: Radiother Oncol Date: 2014-06-03 Impact factor: 6.280
Authors: Alejandra Méndez Romero; Wouter Wunderink; Shahid M Hussain; Jacco A De Pooter; Ben J M Heijmen; Peter C J M Nowak; Joost J Nuyttens; Rene P Brandwijk; Cees Verhoef; Jan N M Ijzermans; Peter C Levendag Journal: Acta Oncol Date: 2006 Impact factor: 4.089
Authors: Jiayi Huang; Todd A DeWees; Shahed N Badiyan; Christina K Speirs; Daniel F Mullen; Sandra Fergus; David D Tran; Gerry Linette; Jian L Campian; Michael R Chicoine; Albert H Kim; Gavin Dunn; Joseph R Simpson; Clifford G Robinson Journal: Int J Radiat Oncol Biol Phys Date: 2015-04-08 Impact factor: 7.038
Authors: Chad Tang; Zhongxing Liao; Daniel Gomez; Lawrence Levy; Yan Zhuang; Rediet A Gebremichael; David S Hong; Ritsuko Komaki; James W Welsh Journal: Int J Radiat Oncol Biol Phys Date: 2014-07-08 Impact factor: 7.038
Authors: Regina V Tse; Maria Hawkins; Gina Lockwood; John J Kim; Bernard Cummings; Jennifer Knox; Morris Sherman; Laura A Dawson Journal: J Clin Oncol Date: 2008-01-02 Impact factor: 44.544
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245
Authors: Luca Boldrini; Angela Romano; Silvia Mariani; Davide Cusumano; Francesco Catucci; Lorenzo Placidi; Gian Carlo Mattiucci; Giuditta Chiloiro; Francesco Cellini; Maria Antonietta Gambacorta; Luca Indovina; Vincenzo Valentini Journal: J Cancer Res Clin Oncol Date: 2021-01-04 Impact factor: 4.553