Long term outcomes of stereotactic body radiation therapy for hepatocellular carcinoma without macrovascular invasion

Mathew, Ashwathy Susan; Atenafu, Eshetu G.; Owen, Dawn; Maurino, C.; Brade, Anthony; Brierley, James D.; Dinniwell, Robert; Kim, John; Cho, Charles; Ringash, Jolie; Wong, Rebecca; Cuneo, Kyle C.; Feng, Mary; Lawrence, Theodore S.; Dawson, Laura A.

doi:10.1016/j.ejca.2020.04.024

Cited by 54 publications

(40 citation statements)

References 28 publications

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“…The local DCR for curative radiotherapy in our hospital was 80% in total and 86.7% for SBRT. The results were consistent with the results of a few clinical studies focusing on the effectiveness of radiotherapy for local treatment of HCC [ 7 , 8 , 9 , 10 , 11 ]. Hara et al reported that the three-year local recurrence rate was significantly lower with radiotherapy than with RFA (5.3% vs. 12.9%) in patients with well-compensated liver function [ 9 ].…”

Section: Discussionsupporting

confidence: 90%

Efficacy and Safety of the Radiotherapy for Liver Cancer: Assessment of Local Controllability and Its Role in Multidisciplinary Therapy

Ohkoshi-Yamada

Kamimura

Shibata

et al. 2020

Cancers

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This study investigated the efficacy and safety of radiotherapy as part of multidisciplinary therapy for advanced hepatocellular carcinoma (HCC). Clinical data of 49 HCC patients treated with radiotherapy were assessed retrospectively. The efficacy of radiotherapy was assessed by progression-free survival, disease control rate, and overall survival. Safety was assessed by symptoms and hematological assay, and changes in hepatic reserve function were determined by Child–Pugh score and albumin–bilirubin (ALBI) score. Forty patients underwent curative radiotherapy, and nine patients with portal vein tumor thrombus (PVTT) underwent palliative radiotherapy as part of multidisciplinary therapy. Local disease control for curative therapy was 80.0% and stereotactic body radiotherapy was 86.7% which was greater than that of conventional radiotherapy (60.0%). Patients with PVTT had a median observation period of 651 days and 75% three-year survival when treated with multitherapy, including radiotherapy for palliative intent, transcatheter arterial chemoembolization, and administration of molecular targeted agents. No adverse events higher than grade 3 and no changes in the Child–Pugh score and ALBI score were seen. Radiotherapy is safe and effective for HCC treatment and can be a part of multidisciplinary therapy.

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Section: Discussionsupporting

confidence: 90%

Efficacy and Safety of the Radiotherapy for Liver Cancer: Assessment of Local Controllability and Its Role in Multidisciplinary Therapy

Ohkoshi-Yamada

Kamimura

Shibata

et al. 2020

Cancers

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“…One of the largest unicentric studies included 185 liver tumors smaller than 5 cm in size and used SBRT in five fractions, reaching doses up to 40 Gy, which could be considered moderate doses, obtaining three-year LC and OS rates of 91% and 70%, respectively [ 19 ]. Mathew et al [ 20 ] reported long-term outcomes for HCC patients without tumor vascular invasion, who were unsuitable for other local treatments from two North American centers. The pooled survival results on 297 patients with 436 lesions showed a 3-year OS rate of 39.0%.…”

Section: Clinical Studies Of Sbrt For Hccmentioning

confidence: 99%

“…Cumulative local recurrence was 13.3% at three years, significantly lower for smaller tumors and in patients able to collaborate with breath-hold techniques. Worsening of CTP score by more than two points three months after SBRT was seen in 15.9% [ 20 ].…”

Section: Clinical Studies Of Sbrt For Hccmentioning

confidence: 99%

Stereotactic Radiotherapy for Hepatocellular Carcinoma, Radiosensitization Strategies and Radiation-Immunotherapy Combination

Pérez-Romasanta

Portillo

Rodríguez-Gutierrez

et al. 2021

Cancers

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Stereotactic body radiotherapy (SBRT) is an emerging ablative modality for hepatocellular carcinoma (HCC). Most patients with HCC have advanced disease at the time of diagnosis, and therefore, are not candidates for definitive-intent therapies such as resection or transplantation. For this reason, various alternative local and regional therapies have been used to prevent disease progression, palliate symptoms, and delay liver failure. Stereotactic body radiation therapy is a non-invasive technique of delivering ablative doses of radiation to tumors while sparing normal or non-tumor hepatic tissue. Incorporation of SBRT in multidisciplinary HCC management is gradual, initially applied when other liver-directed therapies have failed or are contraindicated, and tried in combination with other locoregional or systemic therapies for more unfavorable conditions by more experienced teams. In order to improve SBRT therapeutic ratio, there has been much interest in augmenting the effect of radiation on tumors by combining it with chemotherapy, molecularly targeted therapeutics, nanoparticles, and immunotherapy. This review aims to synthesize available evidence to evaluate the clinical feasibility and efficacy of SBRT for HCC, and to explore novel radio-potentiation concepts by combining SBRT with novel therapeutics. It is expected that those approaches would result in improved therapeutic outcomes, even though many questions remain with regard to the optimal way to assemble treatments. Further trials are needed to evaluate and consolidate these promising therapies for HCC.

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“…Highly conformal radiation techniques with intensity modulated radiation therapy and stereotactic body radiation therapy have enabled radiation oncologists to play an increasingly valuable role in the treatment of patients with HCC. 6 HTLV-1 infects about 20 million people worldwide, with a high prevalence in southwestern Japan, the Caribbean Islands, and parts of Central Africa and South America. This RNA virus infects T-cells, B-lymphocytes, and monocytes and can trigger adult T-cell leukemia.…”

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confidence: 99%

mentioning

confidence: 99%

Life Beyond COVID: Pay Attention to Viruses

Harari

Lambert

2020

International Journal of Radiation Oncology*Biology*Physics

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Long term outcomes of stereotactic body radiation therapy for hepatocellular carcinoma without macrovascular invasion

Cited by 54 publications

References 28 publications

Efficacy and Safety of the Radiotherapy for Liver Cancer: Assessment of Local Controllability and Its Role in Multidisciplinary Therapy

Efficacy and Safety of the Radiotherapy for Liver Cancer: Assessment of Local Controllability and Its Role in Multidisciplinary Therapy

Stereotactic Radiotherapy for Hepatocellular Carcinoma, Radiosensitization Strategies and Radiation-Immunotherapy Combination

Life Beyond COVID: Pay Attention to Viruses

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