Stereotactic Body Radiation Therapy for Liver Tumors: Current Status and Perspectives

Doi, Hiroshi; Beppu, Naohito; Kitajima, Kazuhiro; Kuribayashi, Kozo

doi:10.21873/anticanres.12263

Cited by 16 publications

(10 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the abundance of literature on clinical prognostic factors, such as size and number of lesions, total radiation dose, fractionation, biological effective dose, techniques, patient factors, performance status, Child-Pugh classification, vascular invasion, thrombosis, and prior treatments, there are no pre-treatment radiotherapy planning criteria with respect to tumor location correlated with survival [9, 17]. We believe this will help the Barcelona Classification of Treatment Guide recently published by the National Cancer Institute, United States (NCI US) [2].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Tumor Location for Liver Cancer Radiotherapy

Dar

McKillop

Vickress

et al. 2018

Cureus

View full text Add to dashboard Cite

IntroductionAccording to the Surveillance, Epidemiology and End Results (SEER) data, cancerous involvement of the liver is on an increase over the last three decades. It occurs worldwide in all races and carries a poor prognosis. Currently, considerable progress has been made in patient selection, staging, surgery, chemotherapy agents, and stereotactic radiotherapy in both primary and metastatic liver cancers with improved outcomes. While there is evidence of the prognostic factors of liver function, the involvement of the portal vein, inferior vena cava thrombosis, lesion size, radiation dose, number of fractions, and SBRT techniques, there is no study evaluating outcomes with the location of the lesion. Our aim in this retrospective study was to explore the correlation of tumor location from the portal vein bifurcation (vascular wall) and the radiotherapy outcome (survival) in hepatocellular cancer.MethodsContrast-enhanced computed tomography (CT) studies in 86 patients with liver cancer were retrospectively reviewed in an institutional review board (IRB)-approved database to determine the distance to the bifurcation point of the portal vein from tumor’s centre of mass (distance tumor bifurcation: DTB) and from the edge point of the planning target volume closest to the bifurcation (distance edge bifurcation: DEB). The mean dose to the sphere of 1 cm diameter around the bifurcation point (mean dose at bifurcation: MDB) was calculated. These parameters were tested as predictors of patient outcomes using univariate and multivariate analysis as two groups of patients.ResultsOnly the DEB correlation with survival for hepatocellular carcinoma (HCC) was found to be significant (P = 0.028). A larger MDB is caused by a smaller DTB and a smaller DEB. The hazard ratio for DTB, DEB, and MDB were 0.48, 0.41, and 1.05, respectively. The DEB was found to be a better predictor of outcomes (overall survival) compared to the DTB and MDB parameters. The close proximity of the tumor to the blood supply vessels was a decisive factor. The DTB parameter is also dependent on the size of the tumor and this factor weakens the correlation of this parameter on survival data. The inclusion of the dosimetric and geometric location, as well as distance parameters in predictive models for liver cancer patients, was shown to benefit the pre-selection of treatment options for liver cancer patients treated with radiotherapy.ConclusionFor hepatocellular cancer patients, the distance between the edge point of the planning treatment volume (PTV) to the portal vein bifurcation (DEB) of more than 2 cm was found to be a predictor of survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Tumor Location for Liver Cancer Radiotherapy

Dar

McKillop

Vickress

et al. 2018

Cureus

View full text Add to dashboard Cite

show abstract

“…The most important dose-limiting factor of SBRT is liver damage. Fortunately, taking the advantages of SBRT's characteristics of delivering high individual doses of radiation to target tumors and keeping rapid fall-off doses to surrounding normal tissues [26], there was no significant deterioration of liver function when compared with the control group (the patients' Child-Pugh score deterioration rates of �2 in case and control groups were 5 and 7, respectively). In the case group, RFA was performed fewer times than in the control group.…”

Section: Groupsmentioning

confidence: 99%

Safety and efficacy study: Short-term application of radiofrequency ablation and stereotactic body radiotherapy for Barcelona Clinical Liver Cancer stage 0–B1 hepatocellular carcinoma

et al. 2021

View full text Add to dashboard Cite

Aim To evaluate the safety and efficacy of the administration of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) in the short term to the same patients in Barcelona Clinical Liver Cancer (BCLC) stages 0–B1. Methods From April 2014 to June 2019, we retrospectively reviewed BCLC stage 0–B1 patients with fresh hepatocellular carcinoma (HCC) lesions that were repeatedly treated by RFA (control group, n = 72), and by RFA and subsequent SBRT (case group, n = 26). Propensity score matching (PSM) was performed to reduce the selection bias between two groups. Recurrence, survival, Child–Pugh scores and short-term side effects (fever, bleeding, skin change, abdominal pain and fatigue) were recorded and analyzed. Results After PSM, 21 patients remained in each group. Seventeen and 20 patients in the case and control groups experienced recurrence. For these patients, the median times to progression and follow-up were 10.7 and 35.8 months, respectively. After PSM, the 1-year progression-free survival rate in case and control groups were 66.7% and 52.4%, respectively (P = 0.313). The inter-group overall survival (OS) was comparable (3 and 5-year OS rates in case groups were 87.3% and 74.8%, while rates in control groups were 73.7% and 46.3%, respectively; P = 0.090). The short-term side effects were mild, and the incidence showed no inter-group difference. The 1-year rates of the Child–Pugh score deterioration of ≥2 in case and control groups were 23.8% and 33.3% (P > 0.05), respectively. Conclusion The short-term administration of RFA and SBRT to the same BCLC stage 0–B1 patients may be feasible and effective because of their good prognosis and safety.

show abstract

“…Radiotherapy-induced liver damage is a dose-limiting liver radiation injury ( 40 , 44 ). As the majority of patients with HCC have a long history of liver cirrhosis, radiotherapy-induced liver damage requires sufficient attention.…”

Section: Treatmentmentioning

confidence: 99%

Diagnosis, treatment and prognosis of hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus (Review)

Xia

Zhang

2020

Oncol Lett

View full text Add to dashboard Cite

Although tumor thrombus (TT) infringement of the inferior vena cava (IVC) and right atrium (RA) is rarely observed in hepatocellular carcinoma (HCC), the prognosis for this condition is extremely poor, with a median survival time of several months, given that the condition is often diagnosed at an advanced tumor stage or combined with multiple systemic metastases. Furthermore, there is no established effective treatment for the condition. However, some investigators insist that active treatment, including surgery, chemotherapy (systemic or intra-arterial), radiation therapy, best supportive care or a combination of these, may help prolong overall survival time in these patients. The management of patients with advanced HCC and a TT extending into the RA and IVC is extremely difficult and risky. To this end, the present review assessed the literature on the clinical features and treatments of this condition in recent years, with the aim of providing assistance for clinical work.

show abstract

Stereotactic Body Radiation Therapy for Liver Tumors: Current Status and Perspectives

Cited by 16 publications

References 66 publications

Prognostic Significance of Tumor Location for Liver Cancer Radiotherapy

Prognostic Significance of Tumor Location for Liver Cancer Radiotherapy

Safety and efficacy study: Short-term application of radiofrequency ablation and stereotactic body radiotherapy for Barcelona Clinical Liver Cancer stage 0–B1 hepatocellular carcinoma

Diagnosis, treatment and prognosis of hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus (Review)

Contact Info

Product

Resources

About