scholarly journals Stereotactic Body Radiotherapy As a Part of Combine Treatment or Single Modality for Patients with Oligometastatic Liver Disease

2019 ◽  
Vol 105 (1) ◽  
pp. E568-E569
Author(s):  
N. Martynova ◽  
N. Vorobyov ◽  
A. Mikhailov ◽  
J. Gutsalo ◽  
A. Kubasov ◽  
...  
Keyword(s):  
Liver Disease ◽  
Combine Treatment ◽  
Stereotactic Body Radiotherapy ◽  
Single Modality

scholarly journals Clinical Values and Markers of Radiation-Induced Liver Disease for Hepatocellular Carcinoma With Portal Vein Tumor Thrombus Treated With Stereotactic Body Radiotherapy

2021 ◽  
Vol 11 ◽  
Author(s):  
Jun Jia ◽  
Jing Sun ◽  
Xuezhang Duan ◽  
Wengang Li
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Liver Disease ◽  
Portal Vein ◽  
Survival Time ◽  
Stereotactic Body Radiotherapy ◽  
Tumor Thrombus ◽  
Portal Vein Tumor Thrombus ◽  
Overall Survival Time ◽  
Radiation Induced

BackgroundInformation about radiation-induced liver disease (RILD) in hepatocellular carcinoma (HCC) patients preexisting hepatitis B cirrhosis with portal vein tumor thrombus (PVTT) extended to the main portal vein treated with stereotactic body radiotherapy (SBRT) is still inadequate and the predictive markers for RILD have not been cleared in these patients. The aim of the study is to identify factors that can be used to predict RILD and to evaluate the influence of RILD in these patients.MethodsIn our study, 59 patients were analyzed and evaluated from December 2015 to June 2019, according to the entry criteria. After treatment, 59 patients were followed up within the first month and then every 3 months. Hematology test, tumor markers, three-phasic CT scan of the lungs, and CT or MRI scan of the liver were performed at each follow up.ResultsMedian overall survival time was 10.7 months (range, 5.8 to 14.9). RILD appeared in 17 of the 59 patients (28.8%) at the 3rd month after SBRT. In the univariate analysis, not only the CP score class (A or B) but also each different pretreatment CP score (p < 0.05) was a significant predictive factor of RILD. More RILD cases were detected with the increase of CP score. The recovery rate decreased as the baseline CP score increased (p < 0.05). It was found that the overall survival time was affected by only baseline CP score and RILD (p < 0.05).ConclusionsThe development of RILD has a dependency on the CP score in these patients. CP scores before treatment and RILD are significantly associated with overall survival. SBRT is an effective and safe method for patients with CP ≤ B7. For patients with CP-B8, liver function should be monitored more frequently. It is not safe enough for the SBRT treatment in CP-B9 patients.

Outcomes following stereotactic body radiotherapy for patients with Child-Pugh B/C hepatocellular carcinoma.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 167-167
Author(s):  
Shaelyn Culleton ◽  
Haiyan Jiang ◽  
Joon-Hyung J. Kim ◽  
James D. Brierley ◽  
Anthony M. Brade ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Liver Function ◽  
Median Survival ◽  
Stereotactic Body Radiotherapy ◽  
Liver Volume ◽  
Impaired Liver Function ◽  
Bridge To Transplant ◽  
Local Progression ◽  
Impaired Liver

167 Background: Assessment of outcomes in patients with hepatocellular carcinoma (HCC) and Child-Pugh B or C liver function treated with stereotactic body radiotherapy (SBRT). Methods: From 2004 – July 2012, 39 patients with HCC and Child-Pugh B/C liver function were treated with SBRT. Inclusion criteria included Child-Pugh B/C, treatment with SBRT, 5 to 15 fractions, and radical or palliative intent. Univariate analyses (UVA) were performed to assess relationships of patient demographics, liver function tests and treatment characteristics on overall survival (OS) and time to progression (TTP). Results: The majority of the 39 patients had Child-Pugh B7 liver function (69%), performance status ECOG 0-1 (82%), radiological evidence of tumor vascular thrombosis (62%) and hepatitis C as underlying liver disease (49%). 10 patients treated as bridge-to-transplant. The median dose was 3300 cGy in 6 fractions (range: 2000-4500 cGy in 5-15 fractions), individualized based on spared liver volume and underlying liver function. The median survival for all patients was 9.9 months (95% CI: 3.4-18.4). UVA demonstrated significantly reduced survival with Child-Pugh score > B7, baseline AFP > 1049 ng/mL (upper quartile) and gross tumor volume > 93 cm3. The median survival of patients treated with SBRT as a bridge-to-transplant versus the non-bridge-to–transplant patients was 30.7 months (95% CI: 0.6-not reached) versus 7.9 months (95% CI: 3.4-15.1; p=0.008). No HCC tumors treated with SBRT demonstrated local progression during the follow-up time. The median TTP for all patients was 18.8 months (95% CI: 6.2-not reached). Model for end stage liver disease (MELD) score > 12 was the only factor associated with reduced TTP on UVA. 31% of patients had a decline in Child-Pugh score by 2 or more points at 3 months. No acute treatment related toxicities of grade 3 or higher were reported. Conclusions: SBRT may be considered as a treatment option for HCC with impaired liver function. Survival is best in patients who are treated as a bridge-to-transplant, have smaller tumors, are Child-Pugh class B7, and have lower AFP levels. Randomized trials of radiation therapy in HCC patients with impaired liver function are warranted.

PO-0769 STEREOTACTIC BODY RADIOTHERAPY ON LIVER METASTASES: RADIATION INDUCED LIVER DISEASE AND TOXICITY ASSESSMENT

2012 ◽  
Vol 103 ◽  
pp. S297-S298
Author(s):  
S. Castiglioni ◽  
A. Tozzi ◽  
S. Arcangeli ◽  
P. Mancosu ◽  
G. Reggiori ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Metastases ◽  
Stereotactic Body Radiotherapy ◽  
Toxicity Assessment ◽  
Radiation Induced

Crystalloid Inclusions in Hepatocyte Mitochondria and Their Similarity to Cytoplasmic Crystalloids

1974 ◽  
Vol 32 ◽  
pp. 198-199
Author(s):  
Odell T. Minick ◽  
Hidejiro Yokoo
Keyword(s):  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
Special Interest ◽  
Structural Variations ◽  
Mitochondrial Alterations ◽  
The Matrix ◽  
Crystalloid Inclusions ◽  
Liver Biopsies

Mitochondrial alterations were studied in 25 liver biopsies from patients with alcoholic liver disease. Of special interest were the morphologic resemblance of certain fine structural variations in mitochondria and crystalloid inclusions. Four types of alterations within mitochondria were found that seemed to relate to cytoplasmic crystalloids.Type 1 alteration consisted of localized groups of cristae, usually oriented in the long direction of the organelle (Fig. 1A). In this plane they appeared serrated at the periphery with blind endings in the matrix. Other sections revealed a system of equally-spaced diagonal lines lengthwise in the mitochondrion with cristae protruding from both ends (Fig. 1B). Profiles of this inclusion were not unlike tangential cuts of a crystalloid structure frequently seen in enlarged mitochondria described below.

Healing gone wrong: convergence of hemostatic pathways and liver fibrosis?

2020 ◽  
Vol 134 (16) ◽  
pp. 2189-2201
Author(s):  
Jessica P.E. Davis ◽  
Stephen H. Caldwell
Keyword(s):  
Wound Healing ◽  
Liver Disease ◽  
Hepatic Fibrosis ◽  
Cell Activation ◽  
Stellate Cell ◽  
Factor Xa ◽  
Clinical Trial Data ◽  
Chronic Liver ◽  
Healing Response ◽  
Wound Healing Response

Abstract Fibrosis results from a disordered wound healing response within the liver with activated hepatic stellate cells laying down dense, collagen-rich extracellular matrix that eventually restricts liver hepatic synthetic function and causes increased sinusoidal resistance. The end result of progressive fibrosis, cirrhosis, is associated with significant morbidity and mortality as well as tremendous economic burden. Fibrosis can be conceptualized as an aberrant wound healing response analogous to a chronic ankle sprain that is driven by chronic liver injury commonly over decades. Two unique aspects of hepatic fibrosis – the chronic nature of insult required and the liver’s unique ability to regenerate – give an opportunity for pharmacologic intervention to stop or slow the pace of fibrosis in patients early in the course of their liver disease. Two potential biologic mechanisms link together hemostasis and fibrosis: focal parenchymal extinction and direct stellate cell activation by thrombin and Factor Xa. Available translational research further supports the role of thrombosis in fibrosis. In this review, we will summarize what is known about the convergence of hemostatic changes and hepatic fibrosis in chronic liver disease and present current preclinical and clinical data exploring the relationship between the two. We will also present clinical trial data that underscores the potential use of anticoagulant therapy as an antifibrotic factor in liver disease.

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