Won Il Jang1, Sun Hyun Bae2, Mi-Sook Kim1, Chul Ju Han3, Su Cheol Park3, Sang Bum Kim4, Eung-Ho Cho4, Chul Won Choi5, Kyung Su Kim5, Sangyoun Hwang6, Jin Ho Kim7, A Ram Chang8, Younghee Park8, Eun Seog Kim9, Woo Chul Kim10, Sunmi Jo11, Hae Jin Park12. 1. Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Korea. 2. Department of Radiation Oncology, Soonchunhyang University College of Medicine, Bucheon, Korea. 3. Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul, Korea. 4. Department of General Surgery, Korea Institute of Radiological and Medical Sciences, Seoul, Korea. 5. Department of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea. 6. Department of Internal Medicine, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea. 7. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. 8. Department of Radiation Oncology, Soonchunhyang University College of Medicine, Seoul, Korea. 9. Department of Radiation Oncology, Soonchunhyang University College of Medicine, Cheonan, Korea. 10. Department of Radiation Oncology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea. 11. Department of Radiation Oncology, Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea. 12. Department of Radiation Oncology, Hanyang University Hospital, Seoul, Korea.
Abstract
BACKGROUND: Although several prospective studies have reported the efficacy of stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC), treatment-related toxicity varies and has not been determined. Therefore, the authors evaluated the safety and efficacy of SBRT for patients with HCC in a hepatitis B virus-endemic area. METHODS: This multicenter phase 2 trial enrolled patients with unresectable HCC. Patients received SBRT with 45 to 60 Gy in 3 fractions. To evaluate gastroduodenal toxicity, esophagogastroduodenoscopy (EGD) was performed before and 2 months after SBRT. The primary endpoint was treatment-related severe toxicity at 1 year after SBRT. The secondary endpoints were the 2-year local control, progression-free survival, and overall survival rates. RESULTS: In total, 74 patients were enrolled between January 2012 and April 2015, and 65 eligible patients were analyzed. One patient experienced radiation-induced liver disease with acute grade ≥3 toxicity 1 month after SBRT. In addition, 1 patient had a grade 3 esophageal ulcer with stenosis 5 months after SBRT. The actuarial rate of treatment-related severe toxicity at 1 year was 3%. The pre-SBRT and post-SBRT EGD findings were not significantly different among the 57 evaluable patients who underwent EGD. The 2-year and 3-year local control rates were 97% and 95%, respectively. The progression-free and overall survival rates were 48% and 84% at 2 years, respectively, and 36% and 76% at 3 years, respectively. CONCLUSIONS: With a median follow-up of 41 months, this prospective multicenter study demonstrated that SBRT for patients with HCC is well tolerated and is an effective treatment modality.
BACKGROUND: Although several prospective studies have reported the efficacy of stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC), treatment-related toxicity varies and has not been determined. Therefore, the authors evaluated the safety and efficacy of SBRT for patients with HCC in a hepatitis B virus-endemic area. METHODS: This multicenter phase 2 trial enrolled patients with unresectable HCC. Patients received SBRT with 45 to 60 Gy in 3 fractions. To evaluate gastroduodenal toxicity, esophagogastroduodenoscopy (EGD) was performed before and 2 months after SBRT. The primary endpoint was treatment-related severe toxicity at 1 year after SBRT. The secondary endpoints were the 2-year local control, progression-free survival, and overall survival rates. RESULTS: In total, 74 patients were enrolled between January 2012 and April 2015, and 65 eligible patients were analyzed. One patient experienced radiation-induced liver disease with acute grade ≥3 toxicity 1 month after SBRT. In addition, 1 patient had a grade 3 esophageal ulcer with stenosis 5 months after SBRT. The actuarial rate of treatment-related severe toxicity at 1 year was 3%. The pre-SBRT and post-SBRT EGD findings were not significantly different among the 57 evaluable patients who underwent EGD. The 2-year and 3-year local control rates were 97% and 95%, respectively. The progression-free and overall survival rates were 48% and 84% at 2 years, respectively, and 36% and 76% at 3 years, respectively. CONCLUSIONS: With a median follow-up of 41 months, this prospective multicenter study demonstrated that SBRT for patients with HCC is well tolerated and is an effective treatment modality.
Authors: Abdul Wahab M Sharfo; Linda Rossi; Maarten L P Dirkx; Sebastiaan Breedveld; Shafak Aluwini; Ben J M Heijmen Journal: Front Oncol Date: 2021-03-19 Impact factor: 6.244
Authors: Ulrike Bauer; Sabine Gerum; Falk Roeder; Stefan Münch; Stephanie E Combs; Alexander B Philipp; Enrico N De Toni; Martha M Kirstein; Arndt Vogel; Carolin Mogler; Bernhard Haller; Jens Neumann; Rickmer F Braren; Marcus R Makowski; Philipp Paprottka; Markus Guba; Fabian Geisler; Roland M Schmid; Andreas Umgelter; Ursula Ehmer Journal: World J Gastroenterol Date: 2021-06-28 Impact factor: 5.742