Steven Gresswell1, Rachel Tobillo2, Shaakir Hasan1, Tadahiro Uemura3, Lorenzo Machado3, Ngoc Thai3, Alexander Kirichenko1. 1. Division of Radiation Oncology, Allegheny Health Network, 320 East North Ave, Pittsburgh, PA 15212, USA. 2. Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA. 3. Division of Transplant Surgery, Allegheny Health Network, 320 East North Ave, Pittsburgh, PA 15212, USA.
Abstract
INTRODUCTION: To report on SBRT as a bridge to OLT for patients with HCC and Child-Pugh ≥8 cirrhosis. METHODS: Retrospective review of 15 patients, treated from 2010-2017. Three patients excluded secondary to delisting from prohibitive substance. Twelve patients (17 lesions) included for final analysis. Hepatic SPECT functional treatment planning utilized. RESULTS: The median age of 60 years with a median CP 9 and MELD 14. The median SBRT dose was 40 Gy in 5 fractions, and median tumor size was 2.3cm (1.2-5.3cm). Median follow-up and survival was 40-months and 46-months, respectively. One patient succumbed to renal/hepatic failure before OLT. Radiographic response was 80%. pCR at explant was 46%. No grade ≥ 3 acute toxicities. Median time to progression of CP ≥ 2 was 9.7-months and MELD progression was not met before OLT. CONCLUSION: SBRT with functional treatment planning can be used safely as a bridge to OLT in select patients with CP ≥8 cirrhosis.
INTRODUCTION: To report on SBRT as a bridge to OLT for patients with HCC and Child-Pugh ≥8 cirrhosis. METHODS: Retrospective review of 15 patients, treated from 2010-2017. Three patients excluded secondary to delisting from prohibitive substance. Twelve patients (17 lesions) included for final analysis. Hepatic SPECT functional treatment planning utilized. RESULTS: The median age of 60 years with a median CP 9 and MELD 14. The median SBRT dose was 40 Gy in 5 fractions, and median tumor size was 2.3cm (1.2-5.3cm). Median follow-up and survival was 40-months and 46-months, respectively. One patient succumbed to renal/hepatic failure before OLT. Radiographic response was 80%. pCR at explant was 46%. No grade ≥ 3 acute toxicities. Median time to progression of CP ≥ 2 was 9.7-months and MELD progression was not met before OLT. CONCLUSION: SBRT with functional treatment planning can be used safely as a bridge to OLT in select patients with CP ≥8 cirrhosis.
Entities:
Keywords:
bridge to transplant; downsizing; hepatic cirrhosis; hepatocellular carcinoma; liver transplantation; stereotactic body radiation treatment
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