Repeated Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

Eriguchi, Takahisa; Tsukamoto, Nobuhiro; Kuroiwa, Nobuko; Nemoto, Takafumi; Ogata, Takeru; Okubo, Yusuke; Nakano, Shigeru; Sugawara, Akitomo

doi:10.1016/j.prro.2020.08.002

Cited by 7 publications

(13 citation statements)

References 35 publications

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“…In regards to this issue, some retrospective studies published in recent years have reported that repeated SBRT for recurrent HCC was safely performed with acceptable hepatic toxicity. [41][42][43] In order to clarify long-term liver toxicities of both treatments, prospective studies in larger numbers of patients are necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, RFA is safely repeated for intrahepatic recurrences and often applied to recurrent HCC in clinical practice, whereas the feasibility of repeated SBRT for recurrent HCC had been unclear. In regards to this issue, some retrospective studies published in recent years have reported that repeated SBRT for recurrent HCC was safely performed with acceptable hepatic toxicity 41–43 . In order to clarify long‐term liver toxicities of both treatments, prospective studies in larger numbers of patients are necessary.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of stereotactic body radiotherapy and radiofrequency ablation for hepatocellular carcinoma: Systematic review and meta‐analysis of propensity score studies

Eriguchi

Takeda

Tateishi

et al. 2021

Hepatology Research

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Aim: Stereotactic body radiotherapy (SBRT) is an emerging treatment for hepatocellular carcinoma (HCC) and has shown excellent local control (LC), as has radiofrequency ablation (RFA). As no randomized controlled trial has compared SBRT and RFA for HCC, data from a propensity score matched study (PSMS) are valuable.However, the results varied greatly and depended on composing factors of Barcelona Clinic Liver Cancer staging (BCLC-factors) adjusted. Therefore, we undertook a systematic review and meta-analyses of the studies focusing on BCLC-factors matching. Methods:We systematically searched PubMed, the Cochrane database, EMBASE, and Web of Science to identify studies comparing RFA and SBRT using propensity scores. The hazard ratios (HRs) of overall survival (OS) and LC from BCLC-factormatched and -unmatched PSMS were pooled. Heterogeneity between the data from these studies was assessed.Results: Three BCLC-factor-matched studies were identified. Stereotactic body radiotherapy led to comparable OS (HR, 0.89; 95% CI, 0.74-1.08; p = 0.24; I 2 = 0%; p for heterogeneity, 0.56) and significantly better LC (HR, 0.39; 95% CI, 0.30-0.51; p < 0.001; I 2 = 0%; p for heterogeneity, 0.67). We also identified three additional BCLC-factor-unmatched studies (HR of OS, 1.41; 95% CI, 1.21-1.65; p < 0.0001; I 2 = 0%; p for heterogeneity, 0.63). However, considerable heterogeneity was observed for HR of OS between BCLC-factor-matched and -unmatched studies (I 2 = 92.6%; p for heterogeneity, 0.0002). Conclusions:When BCLC-factors were properly adjusted, the results of the metaanalysis revealed equivalent OS and better LC for SBRT compared with RFA. Stereotactic body radiotherapy could be an alternative treatment option for HCC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of stereotactic body radiotherapy and radiofrequency ablation for hepatocellular carcinoma: Systematic review and meta‐analysis of propensity score studies

Eriguchi

Takeda

Tateishi

et al. 2021

Hepatology Research

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“…There are also reports that SBRT can safely and effectively utilized as a bridge to transplantation for HCC (119,120). In addition, repeat SBRT appears feasible with minimal toxicity in the setting of HCC recurrence following an initial course of SBRT (121). While these results are promising, prospective studies are needed.…”

Section: Stereotactic Body Radiation Therapy (Sbrt)mentioning

confidence: 99%

Liver-Directed Treatment Options Following Liver Tumor Recurrence: A Review of the Literature

2022

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Recurrence following curative-intent hepatectomy for colorectal cancer liver metastasis, hepatocellular carcinoma, or cholangiocarcinoma is unfortunately common with a reported incidence as high as 75%. Various treatment modalities can improve survival following disease recurrence. A review of the literature was performed using PubMed. In addition to systemic therapy, liver-directed treatment options for recurrent liver disease include repeat hepatectomy, salvage liver transplantation, radiofrequency or microwave ablation, intra-arterial therapy, and stereotactic body radiation therapy. Repeat resection can be consider for patients with limited recurrent disease that meets resection criteria, as this therapeutic approach can provide a survival benefit and is potentially curative in a subset of patients. Salvage liver transplantation for recurrent hepatocellular carcinoma is another option, which has been associated with a 5-year survival of 50%. Salvage transplantation may be an option in particular for patients who are not candidates for resection due to underlying liver dysfunction but meet criteria for transplantation. Ablation is another modality to treat patients who recur with smaller tumors and are not surgical candidates due to comorbidity, liver dysfunction, or tumor location. For patients with inoperable disease, transarterial chemoembolization, or radioembolization with Yttrium-90 are liver-directed intra-arterial therapy modalities with relatively low risks that can be utilized. Stereotactic body radiation therapy is another palliative treatment option that can provide a response and local tumor control for smaller tumors.

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“…Specific methods include associating liver partition and portal vein ligation for staged hepatectomy, ablation, TACE, HAIC, SBRT, CCRT, TARE, TKIs, ICIs, and multimodality treatment approaches (16,18,42,43). Conversion outcomes of various approaches are cited in Table 3 (16,18,42,(44)(45)(46). Despite controversies, mounting data have indicated that successful conversion treatment followed by subsequent surgery is achievable in the population of patients with advanced HCC (47).…”

Section: Current Status Of Conversion Therapy For Advanced Hccmentioning

confidence: 99%

Conversion therapy with an immune checkpoint inhibitor and an antiangiogenic drug for advanced hepatocellular carcinoma: A review

Tang

Cao

Jian³

et al. 2022

BST

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Hepatocellular carcinoma (HCC) has been the fifth most common malignancy worldwide and is the second most common cause of tumor-related mortality globally. In China, a high proportion of patients with HCC present with an advanced stage of the disease, so HCC is a major challenge to the healthcare system and a substantial socioeconomic burden. The last decade has witnessed an expansion of the treatment landscape for HCC. Various approaches have been explored as potential conversion therapies for advanced HCC. Despite controversies, mounting data have indicated that successful conversion therapy followed by subsequent surgery is achievable in a population of patients with advanced HCC. This conversion therapy is a safe and promising treatment strategy to prolong long-term outcomes. Based on preliminary research, this review has assembled and summarized current clinical experience with and evidence of the efficacy of conversion therapies followed by subsequent surgery for advanced HCC.

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Repeated Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

Cited by 7 publications

References 35 publications

Comparison of stereotactic body radiotherapy and radiofrequency ablation for hepatocellular carcinoma: Systematic review and meta‐analysis of propensity score studies

Comparison of stereotactic body radiotherapy and radiofrequency ablation for hepatocellular carcinoma: Systematic review and meta‐analysis of propensity score studies

Liver-Directed Treatment Options Following Liver Tumor Recurrence: A Review of the Literature

Conversion therapy with an immune checkpoint inhibitor and an antiangiogenic drug for advanced hepatocellular carcinoma: A review

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