Adjuvant stereotactic body radiotherapy following transarterial chemoembolization in patients with non‐resectable hepatocellular carcinoma tumours of ≥3 cm

Jacob, Rojymon; Turley, Falynn; Redden, David T.; Saddekni, Souheil; Aal, Ahmed Kamel Abdel; Keene, K.S.; Yang, Eddy S.; Zarzour, Jessica G.; Bolus, David N.; Smith, Jillian K.; Gray, Stephen H.; White, Jared; Eckhoff, Devin E.; DuBay, Derek A.

doi:10.1111/hpb.12331

Cited by 69 publications

(69 citation statements)

References 32 publications

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“…Both studies found that the addition of SBRT resulted in improved local control with no increase in high-grade toxicity. Furthermore, in tumours ≥3cm, after censoring for liver transplantation, overall survival was significantly better with TACE plus SBRT compared to TACE alone (median survival 33 and 20 months respectively; p=0.02) 32 . There was no overall survival advantage from the combination in tumours ≤3cm, although disease free survival (DFS) was significantly better with the addition of SBRT in treatment naïve patients (1-year DFS 71.4% and 24.8% respectively, p=0.029) 33 .…”

Section: Clinical Evidence: Prospective Datamentioning

confidence: 95%

“…Normal liver doses and the severity of cirrhosis are important in predicting hepatic toxicity 15,16,[25][26][27] . Classic and non-classic radiation-induced liver disease (RILD) have been described 28 SBRT and TACE to TACE alone in tumours ≥3cm and ≤3cm respectively in retrospective series 32,33 . Both studies found that the addition of SBRT resulted in improved local control with no increase in high-grade toxicity.…”

Section: Clinical Evidence: Prospective Datamentioning

confidence: 99%

“…CBCT matching has been suggested to be superior to orthogonal x-rays 56 . The use of peri-tumoral fiducials, with both x-rays and CBCT can further enhance set-up 21,26,31,32,34,52,57 . The presence of lipiodal following TACE, or surgical clips, have also been used as surrogates for tumour position 21,26 .…”

Section: Image Guidancementioning

confidence: 99%

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Advances in Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

Murray

Dawson

2017

Seminars in Radiation Oncology

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SBRT is an emerging effective treatment for hepatocellular carcinoma (HCC) associated with acceptable rates of toxicity in appropriately selected patients. Despite often being reserved for patients unsuitable for other local treatments, prospective and retrospective studies have demonstrated excellent long-term control. SBRT may be used as a stand-alone treatment, or as an adjunct to other HCC therapies. Based on available data, SBRT appears to complement existing local liver therapies.Randomised and non-randomized comparative studies are required to better determine the optimal role of SBRT in HCC treatment.

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Section: Clinical Evidence: Prospective Datamentioning

confidence: 95%

Section: Clinical Evidence: Prospective Datamentioning

confidence: 99%

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Advances in Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

Murray

Dawson

2017

Seminars in Radiation Oncology

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“…It can be a treatment for HCC with >3 cm tumour size. 159 In a retrospective study the effect of the combination of TACE + 3-DCRT + HIFU was evaluated. After the combination of TACE and 3-DCRT, HIFU was administered.…”

Section: Chemotherapy and Radiotherapymentioning

confidence: 99%

New modalities of treatment for hepatocellular carcinoma

Behnagh

Rezaei

Jahannia

et al. 2017

J. contemp. med. sci.

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Hepatocellular carcinoma (HCC) is the second most common cause of death from cancer worldwide. Managing HCC is difficult. However, there are many treatment options available such as liver transplantation, radiotherapy, different ablative techniques, surgery, trans-arterial chemoembolization (TACE) and systemic therapy. These treatments did not show the promising responses and the recurrence rate is still high. On the other hand, there are some new treatments such as immunotherapy, gene therapy, combination of different therapies, Chinese traditional therapies and new targeted therapies. The aim of this study is to review both the recent changes in the common therapies and newly developed therapies of HCC.

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“…SBRT can be a complementary treatment to TACE, since the ischemic effects of TACE are less potent in the surrounding well-oxygenated periphery of the HCC tumor where radiation is the most effective. A retrospective study suggests a survival advantage in large tumors for the combination of SBRT and TACE as compared to TACE alone [52] . Due to the limited data regarding SBRT, it is considered under investigation, and not yet recommended by the EASL guidelines as part of the HCC therapy regimen.…”

Section: Stereotactic Body Radiotherapymentioning

confidence: 99%

Treatment of hepatocellular carcinoma: Steps forward but still a long way to go

Mlynarsky

Menachem

Shibolet

2015

WJH

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Hepatocellular carcinoma (HCC) is the fifth most common malignancy and the third cause of tumor associated deaths worldwide. HCC incidence rates are increasing in many parts of the world including developing and developed countries. Potentially curative treatments for HCC are resection and liver transplantation, but these are only suitable for patients with small tumors, meeting strict pre-defined criteria, or well-compensated liver disease. Early diagnosis of HCC can be achieved by surveillance of at-risk populations. For patients with non-resectable disease treatments modalities include loco-ablative and systemic therapies. In this review we focus on treatment options in HCC and their allocation. Although significant research is in progress, to this date, the results are unsatisfactory with limited long-term survival. In the fight against this deadly disease, there is still a long way to go. Core tip: We chose to focus on the aspect of treatment modalities of hepatocellular carcinoma (HCC) and discuss the benefits and disadvantages of each modality. We report on the diversity of treatments and the allocation of patients with HCC to the different modalities according to the Barcelona-Clinic Liver Cancer. Moreover, we discuss novel treatments currently under investigation and not yet recommended by acceptable guidelines.

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Adjuvant stereotactic body radiotherapy following transarterial chemoembolization in patients with non‐resectable hepatocellular carcinoma tumours of ≥3 cm

Abstract: This retrospective study suggests that in patients with HCC tumours of ≥ 3 cm, treatment with TACE + SBRT provides a survival advantage over treatment with only TACE. Confirmation of this observation requires that the concept be tested in a prospective, randomized clinical trial.

Cited by 69 publications

References 32 publications

Advances in Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

Advances in Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

New modalities of treatment for hepatocellular carcinoma

Treatment of hepatocellular carcinoma: Steps forward but still a long way to go

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