Radiotherapy for osseous metastases from hepatocellular carcinoma: a retrospective study of 57 patients

Kaizu, Toshihide; Karasawa, Kazunari; Tanaka, Yoshiaki; Matuda, T.; Kurosaki, Hiromasa; Tanaka, Satoshi; Kumazaki, Tatsuo

doi:10.1016/s0002-9270(98)00495-x

Cited by 51 publications

(40 citation statements)

References 18 publications

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“…In another study, Kaizu et al reported on the use of radiation and noted that higher doses (48 Gy/2 Gy fxs, 39 Gy/3 Gy fxs) were associated with improved tumor responses when compared with lower standard palliative doses of RT (30 Gy/3 Gy fxs). 34 In this study the response rate was 83.8%, and the median survival period from the time of the initial occurrence of a bone metastasis was 6 months. Other studies have similarly suggested that radiation therapy can be associated with palliative relief of symptomatic recurrent metastatic disease.…”

Section: Introductionmentioning

confidence: 56%

Multidisciplinary Management of Recurrent Hepatocellular Carcinoma Following Liver Transplantation

Kneuertz

Cosgrove

Cameron

et al. 2012

Journal of Gastrointestinal Surgery

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Introduction Tumor recurrence remains a main limitation to the long-term survival of patients following liver transplantation for hepatocellular carcinoma (HCC). While the majority of patients recur in the first two years after transplantation, late recurrence is not infrequent. Discussion Most common sites of recurrence in order of decreasing frequency are liver graft, lung, bone, abdominal lymph nodes, adrenal glands and peritoneum. Reported five-year survival after surgical resection ranges from 27-88%. Few patients, however, are candidates for surgical resection. Other therapeutic options for recurrent HCC include systemic therapy, intra-arterial therapy, or radiation therapy. Although systemic molecular targeted therapy is generally tolerated with very few interactions with immunosuppressive medications, there is only modest success regarding prolongation of survival. Utilization of radiation therapy for extrahepatic recurrences similarly has minimal impact on overall survival, but may effectively in palliate symptoms. While late recurrence is associated with a more favorable prognosis than early recurrences, prognosis is still poor. Conclusion Late recurrence of HCC following transplantation should be borne in mind even after many years from transplant. Surgical salvage, when feasible, remains a viable treatment option in select patients with a chance for long-term survival. A multi-disciplinary approach is critical as different therapeutic modalities have a role in treating recurrent HCC following transplant.

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Section: Introductionmentioning

confidence: 56%

Multidisciplinary Management of Recurrent Hepatocellular Carcinoma Following Liver Transplantation

Kneuertz

Cosgrove

Cameron

et al. 2012

Journal of Gastrointestinal Surgery

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“…There are several reports on the clinical effectiveness of radiotherapy for bone metastases from HCC [6,12,13,14,15,16]. In those reports, pain relief was obtained in 79±100 % of bone metastases from HCC.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter arterial embolization for bone metastases from hepatocellular carcinoma

et al. 2001

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The objective of this study was to determine which of the following three methods is the most effective for the treatment of bone metastases from hepatocellular carcinoma (HCC): transcatheter arterial embolization (TAE); combination of TAE and external radiotherapy; or external radiotherapy alone. Thirty-nine metastatic bone lesions from HCC in 33 patients were retrospectively reviewed. Each lesion underwent either TAE alone (group A, n = 11), TAE followed by radiotherapy (group B, n = 17), or radiotherapy alone (group C, n = 11). They were evaluated on the following subjects: pain relief; improvement of daily activities; and complications. Each treatment was effective for pain relief (89-94%) and improvement of daily activities (73-82%). The mean time interval from the beginning of each treatment to the onset of initial pain relief was 4.7 days in group A, 4.8 days in group B, and 15 days in group C. Recurrence of the pain after the initial pain relief was noted in 75% in group A, 20% in group B, and 88% in group C. Pyrexia and local pain commonly occurred after TAE. In conclusion, TAE is effective in relieving pain immediately and in improving the patients' daily activities. The combination of TAE and radiotherapy is recommended for permanent pain relief.

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“…Some reports have suggested that there are a considerable number of re-irradiation cases which have responded initially due to an insufficient radiotherapy dose. The commonly used palliative irradiation dose may be not enough to control spinal bone metastases from hepatocellular carcinoma or pancreatobiliary cancer [3]. …”

Section: Introductionmentioning

confidence: 99%

Helical tomotherapy for spine oligometastases from gastrointestinal malignancies

et al. 2011

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PurposeThis study evaluated the treatment effectiveness and proper radiation dose of helical tomotherapy (HT) in spine oligometastases from gastrointestinal cancers.Materials and MethodsFrom 2006 to 2010, 20 gastrointestinal cancer patients were treated with HT for spine oligometastases (31 spine lesions). The gross tumor volume (GTV) was the tumor evident from magnetic resonance imaging images fused with simulation computed tomography images. Clinical target volume (CTV) encompassed involved vertebral bodies or dorsal elements. We assumed that the planning target volume was equal to the CTV. We assessed local control rate after HT for 31 spine metastases. Pain response was scored by using a numeric pain intensity scale (NPIS, from 0 to 10).ResultsSpine metastatic lesions were treated with median dose of 40 Gy (range, 24 to 51 Gy) and median 5 Gy per fraction (range, 2.5 to 8 Gy) to GTV with median 8 fractions (range, 3 to 20 fraction). Median biologically equivalent dose (BED, α/β = 10 Gy) was 52 Gy10 (range, 37.5 to 76.8 Gy10) to GTV. Six month local control rate for spine metastasis was 90.3%. Overall infield failure rate was 15% and outfield failure rate was 75%. Most patients showed pain relief after HT (93.8%). Median local recurrence free survival was 3 months. BED over 57 Gy10 and oligometastases were identified as prognostic factors associated with improved local progression free survival (p = 0.012, p = 0.041).ConclusionHT was capable of delivering higher BED to metastatic lesions in close proximity of the spinal cord. Spine metastases from gastrointestinal tumors were sensitive to high dose radiation, and BED (α/β = 10 Gy) higher than 57 Gy10 could improve local control.

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Radiotherapy for osseous metastases from hepatocellular carcinoma: a retrospective study of 57 patients

Abstract: Radiation therapy was effective for bone metastases from HCC, especially for those treated with a TDF value of > or = 77.

Cited by 51 publications

References 18 publications

Multidisciplinary Management of Recurrent Hepatocellular Carcinoma Following Liver Transplantation

Multidisciplinary Management of Recurrent Hepatocellular Carcinoma Following Liver Transplantation

Transcatheter arterial embolization for bone metastases from hepatocellular carcinoma

Helical tomotherapy for spine oligometastases from gastrointestinal malignancies

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