A feasibility study evaluating the relationship between dose and focal liver reaction in stereotactic ablative radiotherapy for liver cancer based on intensity change of Gd-EOB-DTPA-enhanced magnetic resonance images

Jung, Sang Hoon; Yu, Jeong Il; Park, Hee Chul; Lim, Do Hoon; Han, Youngyih

doi:10.3857/roj.2016.34.1.64

Cited by 15 publications

(14 citation statements)

References 34 publications

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“…All patients were educated and trained in controlling their respiration reproducibly and regularly using a visual prompting device before the beginning of a simulation, as previously described by Jung et al [ 18 ] at the same institution. A personalized vacuum cushion facilitated patient immobilization in a supine position and four-dimensional (4D) computed tomography (CT) scanning was performed while the patient breathed with visual guidance from the simulation.…”

Section: Methodsmentioning

confidence: 99%

Is higher dose always the right answer in stereotactic body radiation therapy for small hepatocellular carcinoma?

Lee

Park

et al. 2018

Radiat Oncol J

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PurposeThis study was conducted to compare clinical outcomes and treatment-related toxicities after stereotactic body radiation therapy (SBRT) with two different dose regimens for small hepatocellular carcinomas (HCC) ≤3 cm in size.Materials and MethodsWe retrospectively reviewed 44 patients with liver-confined HCC treated between 2009 and 2014 with SBRT. Total doses of 45 Gy (n = 10) or 60 Gy (n = 34) in 3 fractions were prescribed to the 95% isodose line covering 95% of the planning target volume. Rates of local control (LC), intrahepatic failure-free survival (IHFFS), distant metastasis-free survival (DMFS), and overall survival (OS) were calculated using the Kaplan-Meier method.ResultsMedian follow-up was 29 months (range, 8 to 64 months). Rates at 1 and 3 years were 97.7% and 95.0% for LC, 97.7% and 80.7% for OS, 76% and 40.5% for IHFFS, and 87.3% and 79.5% for DMFS. Five patients (11.4%) experienced degradation of albumin-bilirubin grade, 2 (4.5%) degradation of Child-Pugh score, and 4 (9.1%) grade 3 or greater laboratory abnormalities within 3 months after SBRT. No significant difference was seen in any oncological outcomes or treatment-related toxicities between the two dose regimens.conclusionsSBRT was highly effective for local control without severe toxicities in patients with HCC smaller than 3 cm. The regimen of a total dose of 45 Gy in 3 fractions was comparable to 60 Gy in efficacy and safety of SBRT for small HCC.

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Section: Methodsmentioning

confidence: 99%

Is higher dose always the right answer in stereotactic body radiation therapy for small hepatocellular carcinoma?

Lee

Park

et al. 2018

Radiat Oncol J

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“…First, patients who consented to participate in our proton therapy clinical trials and who registered at clinicaltrials.gov (NCT02632864 and NCT02571946) were considered. Second, for patients indicated for SABR in our institution, treatment was determined considering the margin (range uncertainty and setup uncertainty) of proton beam and liver volume exposures greater than 24 Gy according to the results of previous studies [ 15 , 16 ]. Patients with lesions exceeding 3 cm, in which SABR was not indicated, but who had the potential for cure with one or two lesions were considered for PBT.…”

Section: Methodsmentioning

confidence: 99%

Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

Yoo

Cho

et al. 2018

Radiat Oncol J

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PurposeThis study aimed to evaluate the initial outcomes of proton beam therapy (PBT) for hepatocellular carcinoma (HCC) in terms of tumor response and safety.Materials and MethodsHCC patients who were not indicated for standard curative local modalities and who were treated with PBT at Samsung Medical Center from January 2016 to February 2017 were enrolled. Toxicity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Tumor response was evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST).ResultsA total of 101 HCC patients treated with PBT were included. Patients were treated with an equivalent dose of 62–92 GyE10. Liver function status was not significantly affected after PBT. Greater than 80% of patients had Child-Pugh class A and albumin-bilirubin (ALBI) grade 1 up to 3-months after PBT. Of 78 patients followed for three months after PBT, infield complete and partial responses were achieved in 54 (69.2%) and 14 (17.9%) patients, respectively.ConclusionPBT treatment of HCC patients showed a favorable infield complete response rate of 69.2% with acceptable acute toxicity. An additional follow-up study of these patients will be conducted.

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“…In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after SABR, a novel method using a three-dimensional dose distribution and change in signal intensity of Gd-EOB-DTPA-enhanced MRI hepatobiliary phase images was suggested. This method was capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MR, as well as determining individual dose for developing FLR [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of liver metastases in oligometastatic patients: initial clinical experience

et al. 2021

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Purpose We aimed to present our initial clinical experience on the implementation of a stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of liver metastases in oligometastatic disease. Materials and Methods Twenty-one patients (24 lesions) with liver metastasis treated with SMART were included in this retrospective study. Step-and-shoot intensity-modulated radiotherapy technique was used with daily plan adaptation. During delivery, real-time imaging was used by acquiring planar magnetic resonance images in sagittal plane for monitoring and gating. Acute and late toxicities were recorded both during treatment and follow-up visits. Results The median follow-up time was 11.6 months (range, 2.2 to 24.6 months). The median delivered total dose was 50 Gy (range, 40 to 60 Gy); with a median fraction number of 5 (range, 3 to 8 fractions) and the median fraction dose was 10 Gy (range, 7.5 to 18 Gy). Ninety-three fractions (83.7%) among 111 fractions were re-optimized. No patients were lost to follow-up and all patients were alive except one at the time of analysis. All of the patients had either complete (80.9%) or partial (19.1%) response at irradiated sites. Estimated 1-year overall survival was 93.3%. Intrahepatic and extrahepatic progression-free survival was 89.7% and 73.5% at 1 year, respectively. There was no grade 3 or higher acute or late toxicities experienced during the treatment and follow-up course. Conclusion SMART represents a new, noninvasive and effective alternative to current ablative radiotherapy methods for treatment of liver metastases in oligometastatic disease with the advantages of better visualization of soft tissue, real-time tumor tracking and potentially reduced toxicity to organs at risk.

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A feasibility study evaluating the relationship between dose and focal liver reaction in stereotactic ablative radiotherapy for liver cancer based on intensity change of Gd-EOB-DTPA-enhanced magnetic resonance images

Cited by 15 publications

References 34 publications

Is higher dose always the right answer in stereotactic body radiation therapy for small hepatocellular carcinoma?

Is higher dose always the right answer in stereotactic body radiation therapy for small hepatocellular carcinoma?

Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

Stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of liver metastases in oligometastatic patients: initial clinical experience

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