Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

2012 ◽  
pp. 261-264 ◽  
Author(s):  
Laura A. Dawson ◽  
Sameh Hashem ◽  
Alexis Bujold
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiation Therapy ◽  
Liver Function ◽  
Randomized Trials ◽  
Stereotactic Body Radiation Therapy ◽  
Great Majority ◽  
High Dose ◽  
Dose Volume ◽  
Systemic Therapies

Overview: Stereotactic body radiotherapy (SBRT), in which highly conformal potent radiation doses are delivered in fewer fractions than traditional radiation therapy (RT), is an increasingly popular treatment for hepatocellular carcinoma (HCC). The great majority of HCCs smaller than 6 cm and with Child-Pugh A liver function are controlled with SBRT with limited toxicity. Long-term local control is reduced in larger tumors, and toxicity is increased in patients with Child-Pugh B or C liver function. SBRT is an effective treatment for tumor vascular thrombi and can lead to sustained vascular recanalization. The first site of recurrence following SBRT is most often within the liver, away from the high dose volume, providing rationale for combining SBRT with regional or systemic therapies. Randomized trials of SBRT are warranted.

SU-E-P-52: Dose-Volume Toxicity Analysis of Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

2015 ◽  
Vol 42 (6Part5) ◽  
pp. 3238-3238
Author(s):  
A Bergamo ◽  
K Kauweloa ◽  
J Daniels ◽  
R Crownover ◽  
P Mavroidis ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Stereotactic Body Radiation ◽  
Dose Volume ◽  
Toxicity Analysis

scholarly journals Long-Term Results of High-Dose 2-Fraction Carbon Ion Radiation Therapy for Hepatocellular Carcinoma

2020 ◽  
Vol 5 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Shigeo Yasuda ◽  
Hirotoshi Kato ◽  
Hiroshi Imada ◽  
Yuka Isozaki ◽  
Goro Kasuya ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiation Therapy ◽  
Long Term Results ◽  
High Dose ◽  
Carbon Ion

scholarly journals Stereotactic Body Radiation Therapy vs. Radiofrequency Ablation for Single Small Hepatocellular Carcinoma: A Propensity-score Matching Analysis of Their Impact on Liver Function and Clinical Outcomes

2021 ◽  
Author(s):  
Masayuki Ueno ◽  
Hiroyuki Takabatake ◽  
Satoshi Itasaka ◽  
Takahisa Kayahara ◽  
Youichi Morimoto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Radiofrequency Ablation ◽  
Local Recurrence ◽  
Propensity Score ◽  
Liver Function ◽  
Stereotactic Body Radiation Therapy ◽  
Propensity Score Matching Analysis ◽  
Small Hcc

Abstract Background: Stereotactic body radiation therapy (SBRT) has high efficacy for early-stage hepatocellular carcinoma (HCC) and is expected as an accepted alternative to radiofrequency ablation (RFA). However, SBRT for HCC may cause subacute liver injury leading to negative clinical outcomes. In this study, we compared changes of liver function and prognosis after SBRT or RFA in patients with single, small HCC by using a propensity-score matching analysis.Methods: We reviewed medical records of 140 patients with single ≤3 cm HCC treated with SBRT or RFA at Kurashiki Central Hospital between January 2014 and February 2019. Changes of albumin-bilirubin (ALBI) score, local recurrence, and overall survival were compared between the propensity-score matched groups (31 patients treated with SBRT and 62 treated with RFA).Results: The ALBI score increased modestly but significantly after SBRT, while it was unchanged in the RFA group; the intergroup difference was statistically significant (p = 0.004). No local recurrence of tumor was identified in the SBRT group, whereas the cumulative recurrence incidence was 9.7% in the RFA group (p = 0.023). Overall survival was not significantly different between the two groups (hazard ratio 1.32, 95% confidence interval 0.60–2.89, p = 0.401).Conclusions: SBRT had modestly negative impact on liver function but better local control of HCC than did RFA. Although long-term follow-up of liver function is necessary with SBRT treatment especially in patients with impaired liver function, SBRT is a satisfactory alternative to RFA for treatment of single, small HCC.

scholarly journals Protocol for an integrated phase II/III randomised controlled trial of transarterial chemotherapy and sorafenib with or without stereotactic body radiation therapy in patients with nonmetastatic unresectable hepatocellular carcinoma

2017 ◽  
Vol 4 (1) ◽  
pp. 31 ◽  
Author(s):  
Supriya Chopra ◽  
Nitin Shetty ◽  
Mahesh Goel ◽  
Reena Engineer ◽  
Karthick Rajamanickam ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Phase Ii ◽  
Stereotactic Body Radiation Therapy ◽  
Controlled Trial ◽  
Phase Iii ◽  
High Dose ◽  
Stereotactic Body Radiation ◽  
Meta Analyses

<p class="abstract"><strong>Background:</strong> Vast majority of patients with hepatocellular carcinoma (HCC) present with unresectable disease. In the last decade results of randomized trials and subsequent meta-analyses established trans-arterial chemoembolization (TACE) as standard of care in patients with Barcelona clinic liver cancer (BCLC) stage B. However, there is clearly a need to investigate additional therapeutic options that would consolidate the initial response to TACE. A recent meta-analyses concluded that addition of radiation to TACE had 10-35% improvement in two-year overall survival, however as results of meta-analyses were based on small studies, the need for conducting a high quality randomized study was highlighted. The present study is designed to investigate the role of high dose stereotactic radiation as consolidation therapy after TACE in patients with non-metastatic unresectable HCC<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> Patients diagnosed with non-metastatic unresectable HCC with BCLC stage B/A (medically inoperable) and Child-Pugh’s score A-B7 will be eligible. The trial will randomize patients into TACE alone arm or TACE followed by stereotactic body radiation therapy (SBRT). The primary aim is to compare in-field progression free survival (PFS) in phase II and overall survival in phase III between the control (TACE) and intervention arm (TACE+SBRT). The secondary aim is to compare cause specific survival, imaging response and quality of life in control and intervention arms<span lang="EN-IN">.</span></p><p class="abstract"><strong>Results:</strong> First analysis of the study has been planned when patient accrued under phase II study have completed 1 year follow up<span lang="EN-IN">.  </span></p><p class="abstract"><strong><span lang="NL"><br /></span></strong></p><p class="abstract"><strong><span lang="NL">Trail Registration: </span></strong><span lang="NL">Clinicaltrials.gov,NCT02794337</span></p>

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