Stereotactic body radiation therapy for primary liver tumors: An effective liver‐directed therapy in the toolbox

Cancer ◽  
2021 ◽  
Author(s):  
Hannah J. Roberts ◽  
Jennifer Y. Wo
2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Malek Kreidieh ◽  
Youssef H. Zeidan ◽  
Ali Shamseddine

Treatment recommendations for primary liver malignancies, including hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA), are complex and require a multidisciplinary approach. Despite surgical options that are potentially curative, options for nonsurgical candidates include systemic therapy, radiotherapy (RT), transarterial chemoembolization (TACE), and radiofrequency ablation (RFA). Stereotactic Body Radiation Therapy (SBRT) is now in routine use for the treatment of lung cancer, and there is growing evidence supporting its use in liver tumors. SBRT has the advantage of delivering ablative radiation doses in a limited number of fractions while minimizing the risk of radiation-induced liver disease (RILD) through highly conformal treatment plans. It should be considered in a multidisciplinary setting for the management of patients with unresectable, locally advanced primary liver malignancies and limited treatment options. Recently, the combination of immunotherapy with SBRT has been proposed to improve antitumor effects through engaging the immune system. This review aims at shedding light on the novel concept of the combination strategy of immune-radiotherapy in liver tumors by exploring the evidence surrounding the use of SBRT and immunotherapy for the treatment of HCC and CCA.


2020 ◽  
Vol 2020 ◽  
Author(s):  
Takuya Shimizuguchi ◽  
Jun Imamura ◽  
Simpei Hashimoto ◽  
Katsuyuki Karasawa

2012 ◽  
Vol 7 (1) ◽  
Author(s):  
Marie-Adele S Kress ◽  
Brian T Collins ◽  
Sean P Collins ◽  
Anatoly Dritschilo ◽  
Gregory Gagnon ◽  
...  

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 245-245
Author(s):  
Kyle Clifford Cuneo ◽  
Yilun Sun ◽  
Matthew J Schipper ◽  
Muneesh Tewari ◽  
Theodore Steven Lawrence ◽  
...  

245 Background: Stereotactic body radiation therapy (SBRT) is an effective treatment for patients with hepatocellular carcinoma or liver metastases. Predictive biomarkers for liver toxicity would allow for careful patient selection and the adaptation of therapy. Prior studies have shown specific miRNAs are elevated prior to clinical signs of toxin induced liver injury. We hypothesized that miRNAs can be used to predict radiation induced liver toxicity prior to clinical manifestations. Methods: As part of an IRB approved clinical trial (NCT01522937) patients with liver tumors underwent a split course of SBRT. All patients underwent liver function testing using indocyanine green clearance (ICG) followed by three SBRT fractions. One month later ICG was reassessed and two more fractions were given if the patient did not have a decline in liver function. Plasma samples were obtained at baseline and 1 month after finishing three of five SBRT fractions for 89 patients. For this exploratory analysis, we selected the 10 patients that had a 2+ point increase in Child-Turcotte-Pugh score within 6 months of completing therapy and 19 additional patients without toxicity. The levels of 752 miRNAs were quantified for each sample using qPCR. We then used a univariate tree based classifier and the elastic net with 10-fold cross validation to calculate the AUC for predicting liver toxicity in individual and small groups of miRNAs, respectively. Results: Several miRNAs were found to be potentially predictive of toxicity on univariate tree based classifier analysis including the liver specific microRNA miR.122.3p, the epithelial specific miR.141.3p and miR.200b.3p, the neuroendocrine related miR.375 and miR.217, and miR.125a.5p which plays a role in hepatitis and regulates ERBB2 and ERBB3 signaling. The elastic net model achieved a conservative AUC estimate of 0.74 +/- 0.04 using 69 baseline miRNAs and 0.76 +/- 0.06 using 11 mid-treatment miRNAs to predict toxicity. Conclusions: Our preliminary analysis of the miRNAome from 29 patients receiving liver SBRT shows promising results for the ability of these markers to select patients at risk for radiation induced liver toxicity. Further validation in a larger patient cohort is needed. Clinical trial information: NCT01522937.


2013 ◽  
Vol 106 ◽  
pp. S285
Author(s):  
E. Nouhaud ◽  
G. Créhange ◽  
A. Cueff ◽  
M. Quivrin ◽  
M. Rouffiac-Thouand ◽  
...  

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