Survival and prognostic factors for patients with advanced hepatocellular carcinoma after stereotactic ablative radiotherapy

Lo, Cheng‐Hsiang; Yang, Juxiang; Liu, Ming-Yueh; Jen, Yee‐Min; Lin, Chun–Shu; Chao, Hsing‐Lung; Huang, Wen‐Yen

doi:10.1371/journal.pone.0177793

Cited by 20 publications

(20 citation statements)

References 28 publications

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“…Numerous retrospective studies have found SBRT to be safe and effective in both small HCC (<5 cm) (23-28) and large HCC (>10 cm) (29)(30)(31). Two-year LC, progressionfree survival, and OS rates ranged from 44-90% (32,33), 39-48% (24,34), and 24-67% (24,35), respectively. Some of this variability may be explained by variability of characteristics between study populations.…”

Section: Retrospective Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Stereotactic body radiation therapy in primary hepatocellular carcinoma: current status and future directions

Lin¹,

Lin²,

Wagner³

et al. 2018

J. Gastrointest. Oncol.

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Stereotactic body radiation therapy (SBRT) is a form of radiation therapy that has been used in the treatment of primary hepatocellular carcinoma (HCC) over the past decade. To evaluate the clinical efficacy of SBRT in primary HCC, a literature search was conducted to identify original research articles published from January 2000 through January 2018 in PubMed on SBRT in HCC. All relevant studies published from 2004 to 2018 were included. Prospective studies demonstrated 2-year local control (LC) rates ranging from 64-95% and overall survival (OS) rates ranging from 34% (2-year) to 65% (3-year). Retrospective studies demonstrated 2-year LC rates of 44-90% and 2-year OS rates of 24-67%. Reported toxicities in primary HCC patients vary but SBRT appears to be relatively well tolerated. Studies comparing SBRT to radiofrequency ablation (RFA) are few, but they suggest SBRT may be more effective than RFA in specific primary HCC populations. Additionally, SBRT appears to increase the efficacy of both transarterial chemoembolization (TACE) and sorafenib in selected primary HCC populations.

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Section: Retrospective Studiesmentioning

confidence: 99%

“…Toxicities included RILD in 10 patients (11.2%), of which 1 was classic RILD and 8 were non-classic RILD, and one met criteria for both types. Two patients went on to die from non-classic RILD (35).…”

Section: Retrospective Studiesmentioning

confidence: 99%

Stereotactic body radiation therapy in primary hepatocellular carcinoma: current status and future directions

Lin¹,

Lin²,

Wagner³

et al. 2018

J. Gastrointest. Oncol.

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“…However, in case of inoperability, prospective studies on SBRT and SBRT with optional TACE in primary HCC showed promising 18-month and 3-year overall survival rates of 72% and up to 67%, respectively [33,34]. SBRT is even feasible in patients with advanced-stage HCC, with 3-year overall survival (OS) rates of 24.3% and 3-year local control rates of 78.1% [35]. Furthermore, there is increasing evidence that SBRT may even be superior to TACE regarding survival and recurrence, and especially after prior TAE/TACE treatment [36,37].…”

Section: Indications For Radiotherapymentioning

confidence: 99%

Radiomics for liver tumours

et al. 2020

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Current research, especially in oncology, increasingly focuses on the integration of quantitative, multiparametric and functional imaging data. In this fast-growing field of research, radiomics may allow for a more sophisticated analysis of imaging data, far beyond the qualitative evaluation of visible tissue changes. Through use of quantitative imaging data, more tailored and tumour-specific diagnostic work-up and individualized treatment concepts may be applied for oncologic patients in the future. This is of special importance in cross-sectional disciplines such as radiology and radiation oncology, with already high and still further increasing use of imaging data in daily clinical practice. Liver targets are generally treated with stereotactic body radiotherapy (SBRT), allowing for local dose escalation while preserving surrounding normal tissue. With the introduction of online target surveillance with implanted markers, 3D-ultrasound on conventional linacs and hybrid magnetic resonance imaging (MRI)-linear accelerators, individualized adaptive radiotherapy is heading towards realization. The use of big data such as radiomics and the integration of artificial intelligence techniques have the potential to further improve image-based treatment planning and structured follow-up, with outcome/toxicity prediction and immediate detection of (oligo)progression. The scope of current research in this innovative field is to identify and critically discuss possible application forms of radiomics, which is why this review tries to summarize current knowledge about interdisciplinary integration of radiomics in oncologic patients, with a focus on investigations of radiotherapy in patients with liver cancer or oligometastases including multiparametric, quantitative data into (radio)-oncologic workflow from disease diagnosis, treatment planning, delivery and patient follow-up.

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“…The clinical outcomes of SBRT for HCC in the previous reports are shown in Table 2. SBRT has been reported to provide 1-, 2-, and 3-year local control rates of 56-100, 53-95, and 51-92%, and 1-, 2-, and 3-year survival rates of 32-100, 55-100, and 21-82% for HCC, respectively [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Figure 1 indicates the local control and overall survival after SBRT, BED 10 ≥ 75 Gy in ≤10 fractions (e.g., 40 Gy/4 fr), for HCC at our institute.…”

Section: Sbrt For Hccmentioning

confidence: 99%

“…Manifestations of liver SBRT toxicity have fatigue, damage to the liver, gastrointestinal tract and biliary duct, cytopenia, dermatitis, and rib fractures ( Table 2) [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Adverse events of radiotherapy depend on the treatment site, and the irradiated doses and volume and are categorized into either acute (typically within 3 months of radiotherapy) or late (months to years after radiotherapy), based on their time of onset [55].…”

Section: Adverse Events Of Sbrt For Hcc In Cirrhotic Liver Risk Factmentioning

confidence: 99%

Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma in Cirrhotic Liver

Doi¹,

Shiomi²,

Oh³

2018

Management of Chronic Liver Diseases - Recent Advances

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In the medically inoperable patients with solitary hepatocellular carcinoma (HCC), local therapies, such as radiofrequency ablation and transarterial chemoembolization, are used as alternatives. However, several factors, including anatomic and vascular variants, make procedures more challenging. Radiotherapy has historically been used as a palliative option for unresectable HCC. However, recent advances in modern radiotherapy, such as stereotactic body radiation therapy (SBRT), have dramatically increased the use of radiotherapy as a curative modality, particularly in cases ineligible for local ablation therapy or surgical resection. SBRT is a modern approach for delivering ablative high doses of irradiation in small volumes. SBRT in liver tumors, including HCC, provided local control with potential survival benefits in patients with inoperable status. However, the following issues remain to be addressed: the difference between primary and metastatic liver cancers; SBRT-related toxicity and prevention; pathological features of liver cancers; and potential SBRT strategies, including radiobiology-based SBRT and SBRT combined with immunotherapy. We summarized the effectiveness of SBRT and patient tolerance of the therapy. In addition, we present the current status and future perspective of SBRT as a treatment option for HCC.

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Survival and prognostic factors for patients with advanced hepatocellular carcinoma after stereotactic ablative radiotherapy

Cited by 20 publications

References 28 publications

Stereotactic body radiation therapy in primary hepatocellular carcinoma: current status and future directions

Stereotactic body radiation therapy in primary hepatocellular carcinoma: current status and future directions

Radiomics for liver tumours

Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma in Cirrhotic Liver

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