Role of External Beam Radiation Therapy in Management of Hepatocellular Carcinoma

Sharma, Hunny

doi:10.1016/j.jceh.2014.05.002

Cited by 11 publications

(10 citation statements)

References 38 publications

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“…The comprehensive term RILD includes conditions such as the different degrees of liver damage after veno-occlusive changes caused by whole or partial liver irradiation, although diagnostic criteria vary [2,3]. Recent reports propose the separation of RILD into "classical" and "nonclassical" forms (Table 1) [4,7,8]. The onset of classical RILD occurs 2-12 weeks after radiation therapy and appears after the whole-liver tolerance considered the most sensitive serum marker [9].…”

Section: The Clinical Features Of Radiation-induced Liver Diseasementioning

confidence: 99%

“…Radiation that damages the subendothelial basement membrane leads to activation and aggregation of platelets and stimulates dormant hepatic stellate cells [3,4]. Damage to the hepatic venule endothelium contributes to the formation of microthrombi that cause venous obstruction, panlobular congestion, hepatocyte loss, and fibrosis mediated by transforming growth factor-β1 (TGF-β1) [15][16][17][18].…”

Section: The Pathological Changes In Irradiated Livermentioning

confidence: 99%

“…Radiation-induced hepatitis is described as "radiation hepatitis", "radiation-induced hepatic toxicity", "radiation-induced liver damage", and "radiation-induced liver disease (RILD)". RILD, which describes clinical and pathological features [1][2][3][4], refers to the severity of liver toxicity after high-dose radiotherapy delivered to large liver volumes or when the whole-liver tolerance dose (30)(31)(32)(33)(34)(35) is exceeded during external beam radiotherapy (RT).…”

Section: Introductionmentioning

confidence: 99%

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Pathology and images of radiation-induced hepatitis: a review article

et al. 2018

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Recent advances in highly conformal radiotherapies greatly extend the indications for radiotherapy of liver tumors. However, because of poor tolerance to hepatic radiation, estimation of the intensity of irradiation of the liver is important, particularly for a cirrhotic liver. Knowledge of radiation-induced hepatitis is important for understanding how to optimize hepatic radiation therapy. Pathological changes of the irradiated liver, which include perivenular fibrosis, sinusoidal obstruction, and damage to Kupffer cells and hepatocytes, can be visualized using clinical imaging techniques. This review article discusses and illustrates the pathological and radiological changes of hepatic tumors and the surrounding parenchyma of the irradiated liver.

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Section: The Clinical Features Of Radiation-induced Liver Diseasementioning

confidence: 99%

Section: The Pathological Changes In Irradiated Livermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pathology and images of radiation-induced hepatitis: a review article

et al. 2018

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“…Although a standardized RTx does not exist for liver, technological advances in the field of treatment planning have recently provided the means for delivering appropriate killing doses to a defined liver lesion, achieving satisfactory therapeutic ratios [ 48 ]. In this way, complications became acceptable.…”

Section: The Role Of Ionizing Radiations In the Management Of Hccmentioning

confidence: 99%

Therapeutic Strategies in HCC: Radiation Modalities

Gallicchio

Nardelli

Mainenti

et al. 2016

BioMed Research International

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Patients with hepatocellular carcinoma (HCC) comply with an advanced disease and are not eligible for radical therapy. In this distressed scenario new treatment options hold great promise; among them transarterial chemoembolization (TACE) and transarterial metabolic radiotherapy (TAMR) have shown efficacy in terms of both tumor shrinking and survival. External radiation therapy (RTx) by using novel three-dimensional conformal radiotherapy has also been used for HCC patients with encouraging results while its role had been limited in the past for the low tolerance of surrounding healthy liver. The rationale of TAMR derives from the idea of delivering exceptional radiation dose locally to the tumor, with cell killing intent, while preserving normal liver from undue exposition and minimizing systemic irradiation. Since the therapeutic efficacy of TACE is being continuously disputed, the TAMR with 131I Lipiodol or 90Y microspheres has gained consideration providing adequate therapeutic responses regardless of few toxicities. The implementation of novel radioisotopes and technological innovations in the field of RTx constitutes an intriguing field of research with important translational aspects. Moreover, the combination of different therapeutic approaches including chemotherapy offers captivating perspectives. We present the role of the radiation-based therapies in hepatocellular carcinoma patients who are not entitled for radical treatment.

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“…The overall 5-year survival rate is only 5–10% [ 2 – 4 ]. Radiotherapy is an effective treatment for locally advanced HCC, but its clinical application is limited because of the poor radiation tolerance of the liver and its surrounding tissues [ 5 , 6 ]. As new radiotherapy technology has been used, such as intensity modulated radiotherapy (IMRT), image guided radiotherapy (IGRT), and three-dimensional conformal radiotherapy (3D-CRT), radiation-induced liver injuries have moderately decreased, but the technical improvement is limited.…”

Section: Introductionmentioning

confidence: 99%

Stattic Enhances Radiosensitivity and Reduces Radio-Induced Migration and Invasion in HCC Cell Lines through an Apoptosis Pathway

Zhu

Wang

et al. 2017

BioMed Research International

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Purpose Signal transducer and activator of transcription factor 3 (STAT3) is involved in tumorigenesis, development, and radioresistance of many solid tumors. The aim of this study is to investigate the effects of stattic (an inhibitor of STAT3) on the radiosensitivity and radio-induced migration and invasion ability in hepatocellular carcinoma (HCC) cell lines. Methods HCC cells were treated with stattic, and cell survival rate was analyzed through CCK-8 assay. Radiosensitivity was evaluated using cloning formation analysis; STAT3, p-STAT3, and apoptosis related proteins were detected by western blot. Radio-induced migration and invasion ability in HCC cells were analyzed by wound-healing assay and transwell test. Results Stattic inhibits the expression of p-STAT3 and reduces cell survival in a dose-dependent manner in HCC cell lines, and the IC50 values for Hep G2, Bel-7402, and SMMC-7721 are 2.94 μM, 2.5 μM, and 5.1 μM, respectively. Cloning formation analysis shows that stattic enhances the radiosensitivity of HCC cells. Wound-healing assay and transwell test show that stattic inhibits radio-induced migration and invasion. Further study indicates that stattic promotes radio-induce apoptosis through regulating the expression of apoptosis related proteins in HCC cells. Conclusion Stattic enhances radiosensitivity and reduces radio-induced migration and invasion ability in HCC cells probably through apoptosis pathway.

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Role of External Beam Radiation Therapy in Management of Hepatocellular Carcinoma

Cited by 11 publications

References 38 publications

Pathology and images of radiation-induced hepatitis: a review article

Pathology and images of radiation-induced hepatitis: a review article

Therapeutic Strategies in HCC: Radiation Modalities

Stattic Enhances Radiosensitivity and Reduces Radio-Induced Migration and Invasion in HCC Cell Lines through an Apoptosis Pathway

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