Tumor response assessment by MRI following stereotactic body radiation therapy for hepatocellular carcinoma

Oldrini, G.; Huertas, Alice; Renard-Oldrini, S.; Taste-George, H.; Vogin, Guillaume; Vallar, Laurent; Salleron, Julia; Henrot, P.

doi:10.1371/journal.pone.0176118

Cited by 27 publications

(39 citation statements)

References 24 publications

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“…Kim et al [ 31 ] emphasized that short-term tumor response does not perfectly coincide with long-term local tumor control. A similar phenomenon was also repeated in the study of SABR for HCC [ 32 - 34 ]. In one study, CR rate was 57% at 3 months, but it continuously increased up to 91.4% at 1-year [ 32 ].…”

Section: Discussionsupporting

confidence: 61%

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Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

Yoo

Cho

et al. 2018

Radiat Oncol J

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PurposeThis study aimed to evaluate the initial outcomes of proton beam therapy (PBT) for hepatocellular carcinoma (HCC) in terms of tumor response and safety.Materials and MethodsHCC patients who were not indicated for standard curative local modalities and who were treated with PBT at Samsung Medical Center from January 2016 to February 2017 were enrolled. Toxicity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Tumor response was evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST).ResultsA total of 101 HCC patients treated with PBT were included. Patients were treated with an equivalent dose of 62–92 GyE10. Liver function status was not significantly affected after PBT. Greater than 80% of patients had Child-Pugh class A and albumin-bilirubin (ALBI) grade 1 up to 3-months after PBT. Of 78 patients followed for three months after PBT, infield complete and partial responses were achieved in 54 (69.2%) and 14 (17.9%) patients, respectively.ConclusionPBT treatment of HCC patients showed a favorable infield complete response rate of 69.2% with acceptable acute toxicity. An additional follow-up study of these patients will be conducted.

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Section: Discussionsupporting

confidence: 61%

“…A similar phenomenon was also repeated in the study of SABR for HCC [ 32 - 34 ]. In one study, CR rate was 57% at 3 months, but it continuously increased up to 91.4% at 1-year [ 32 ].…”

Section: Discussionsupporting

confidence: 61%

Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

Yoo

Cho

et al. 2018

Radiat Oncol J

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“… 61 The LR-TR is based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST), and European Association for the Study of Liver Diseases (EASL) which define response assessment based on the volume of residual arterial hyperenhancement as a surrogate for tumor necrosis. 4 , 62 - 64 …”

Section: Introductionmentioning

confidence: 99%

Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma: Current Trends and Controversies

Schaub

Hartvigson

Lock

et al. 2018

Technol Cancer Res Treat

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Hepatocellular carcinoma is the fourth leading cause of cancer-related death worldwide. Depending on the extent of disease and competing comorbidities for mortality, multiple liver-directed therapy options exist for the treatment of hepatocellular carcinoma. Advancements in radiation oncology have led to the emergence of stereotactic body radiation therapy as a promising liver-directed therapy, which delivers high doses of radiation with a steep dose gradient to maximize local tumor control and minimize radiation-induced treatment toxicity. In this study, we review the current clinical data as well as the unresolved issues and controversies regarding stereotactic body radiation therapy for hepatocellular carcinoma: (1) Is there a radiation dose–response relationship with hepatocellular carcinoma? (2) What are the optimal dosimetric predictors of radiation-induced liver disease, and do they differ for patients with varying liver function? (3) How do we assess treatment response on imaging? (4) How does stereotactic body radiation therapy compare to other liver-directed therapy modalities, including proton beam therapy? Based on the current literature discussed, this review highlights future possible research and clinical directions.

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“…Radiotherapy is an increasingly important modality for treating liver tumors, whether they are primary hepatocellular carcinomas or liver metastases [ 1 – 4 ]. However, respiration causes significant motion of the liver [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of respiration-induced motion of each liver segment with helical computed tomography and 4-dimensional computed tomography

Tsai

Shaw

et al. 2018

Radiat Oncol

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BackgroundTo analyze the respiratory-induced motion of each liver segment using helical computed tomography (helical CT) and 4-dimensional computed tomography (4DCT), and to establish the individual segment expansion margin of internal target volume (ITV) to facilitate target delineation of tumors in different liver segments.MethodsTwenty patients who received radiotherapy with CT-simulation scanning of the whole liver in both helical CT and 10-phase-gated 4DCT were investigated, including 2 patients with esophagus cancer, 4 with lung cancer, 10 with breast cancer, 2 with liver cancer, 1 with thymoma, and 1 with gastric diffuse large B-cell lymphoma (DLBCL). For each patient, 9 representative points were drawn on the helical CT images of liver segments 1, 2, 3, 4a, 4b, 5, 6, 7, and 8, respectively, and adaptively deformed to 2 phases of the 4DCT images at the end of inspiration (phase 0 CT) and expiration (phase 50 CT) in the treatment planning system. Using the amplitude of each point between phase 0 CT and phase 50 CT, we established quantitative data for the respiration-induced motion of each liver segment in 3-dimensional directions. Moreover, using the amplitude between the original helical CT and both 4DCT images, we rendered the individual segment expansion margin of ITV for hepatic target delineation to cover more than 95% of each tumor.ResultsThe average amplitude (mean ± standard deviation) was 0.6 ± 3.0 mm in the left-right (LR) direction, 2.3 ± 2.4 mm in the anterior-posterior (AP) direction, and 5.7 ± 3.4 mm in the superior-inferior (SI) direction, respectively. All of the segments moved posteriorly and superiorly during expiration. Segment 7 had the largest amplitude in the SI direction, at 8.6 ± 3.4 mm. Otherwise, the segments over the lateral side, including segments 2, 3, 6, and 7, had greater excursion in the SI direction compared to the medial segments. To cover more than 95% of each tumor, the required expansion margin of ITV in the LR, AP, and SI directions were at least 2.5 mm, 2.5 mm, and 5.0 mm on average, respectively, with variations between different segments.ConclusionsThe greatest excursion occurred in liver segment 7, followed by the segments over the lateral side in the SI direction. The individual segment expansion margin of ITV is required to delineate targets for each segment and direction.

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Tumor response assessment by MRI following stereotactic body radiation therapy for hepatocellular carcinoma

Cited by 27 publications

References 24 publications

Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma: Current Trends and Controversies

Quantitative analysis of respiration-induced motion of each liver segment with helical computed tomography and 4-dimensional computed tomography

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