Validation of the liver mean dose in terms of the biological effective dose for the prevention of radiation-induced liver damage

Doi, Hiroshi; Masai, Norihisa; Uemoto, Kenji; Сузукі, Осаму; Shiomi, Hiroya; Tatsumi, Daisaku; Oh, Ryoong‐Jin

doi:10.1016/j.rpor.2017.02.011

Cited by 11 publications

(12 citation statements)

References 34 publications

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“…The liver is a radiosensitive organ and patients with HCC frequently demonstrate background liver cirrhosis and potential liver dysfunction. In addition, as the PTV volumes positively correlate with the irradiated dose of the liver 35 , the goal in radiotherapy for locally advanced HCC is to decrease the irradiated dose to the liver and the risk of developing RILD. If the PTV is located near the gastrointestinal organs, the irradiated dose of these organs should also be lowered sufficiently to prevent haemorrhage, ulcers, and strictures.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Stereotactic Body Radiotherapy to Portal Vein Tumour Thrombus in Hepatocellular Carcinoma: Clinical and Pathological Analysis

Kishi

Kanayama

Hirata

et al. 2020

Sci Rep

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& teruki teshima 1 the prognosis of hepatocellular carcinoma (Hcc) with portal vein tumour thrombus (pVtt) is poor. We conducted a prospective study to evaluate the efficacy and safety of tri-modality therapy, including preoperative stereotactic body radiotherapy (SBRt) and surgery, followed by hepatic arterial infusion chemotherapy (HAic) in Hcc patients with pVtt. in this report, we investigated the pathology of the irradiated PVTT specimen in resected cases and SBRT-related acute toxicity. A total of 8 HCC patients with PVTT received preoperative SBRT targeting the PVTT at a dose of 48 Gy in 4 fractions at our institute from 2012 to 2016. Of the eight patients, six underwent surgery, while the remaining two did not because of disease progression. At the pathological examination, all patients' irradiated pVtt specimens showed necrotic tissue, and three of six patients showed complete pathological response. Two patients showed 30% necrosis with high degeneration and one patient, with 30% necrosis without degeneration, was the only recurrent case found during the follow-up period (median: 22.5, range: 5.9-49.6 months). No SBRT-related acute toxicity worse than grade 2 was observed from SBRT to surgery. In conclusion, the preoperative SBRT for HCC was pathologically effective and the acute toxicities were tolerable.

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Section: Discussionmentioning

confidence: 99%

Preoperative Stereotactic Body Radiotherapy to Portal Vein Tumour Thrombus in Hepatocellular Carcinoma: Clinical and Pathological Analysis

Kishi

Kanayama

Hirata

et al. 2020

Sci Rep

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“…Sanuki et al and Takeda et al estimated a >90% probability of 3-year local control with 40 Gy in 5 fractions (BED 10 =72 Gy) that was intended to enclose the planning target volume (PTV) by the 80% isodose-line of the maximum dose (15,16). Based on these data, we treated HCC with >80 Gy of BED 10 designed to deliver 100% of the prescription dose to 95% of the PTV using intensitymodulated radiation therapy (IMRT) (40,41). Notably, when there was no constraint on the PTV during planning, the maximum dose for PTV could be slightly escalated from the prescription doses ( Figure 1).…”

Section: Prescription Doses Of Sbrt For Liver Tumorsmentioning

confidence: 99%

“…suggested for SBRT for liver tumors (40,41). Intrahepatic recurrence often occurs after radical treatment for both HCC and metastatic liver tumors, and such tumors have a chance to receive second radical treatment (5,6).…”

Section: Hcc Of 24 MM In Diameter Was Present Just Beneath the Diaphrmentioning

confidence: 99%

“…The doses that the liver receives have a strong positive relationship with the irradiated target volume (41,54). Particle therapy can reduce the liver volume that receives low to intermediate doses, resulting in the reduction of mean liver doses (55).…”

Section: Hcc Of 24 MM In Diameter Was Present Just Beneath the Diaphrmentioning

confidence: 99%

“…Larger tumors are usually a SBRT exclusion criterion, although the response to SBRT in cases of relatively small tumors remains unclear (16,22,24,34,41).…”

Section: Current Issues and Future Perspective Of Liver Sbrtmentioning

confidence: 99%

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

Doi

Beppu

Kitajima

et al. 2018

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Surgical resection is the standard therapy for solitary primary or metastatic liver tumors. However, liver tumors are often unresectable at diagnosis and hepatectomy is invasive. Local therapies, such as radiofrequency ablation, are used instead, which can be challenging. Recent advances in modern radiotherapy, including stereotactic body radiation therapy (SBRT), have increased the use of radiotherapy as a curative modality. SBRT delivers ablative high doses of irradiation in small volumes. SBRT for liver tumors provided local control with potential survival benefits in patients with inoperable status. However, the following issues remain: primary vs. metastatic liver cancers; SBRT-related toxicity and prevention; pathological features of liver cancers; and potential SBRT strategies. We summarized a literature review to summarize the effectiveness of SBRT and patient tolerance and present the current status and future perspective of SBRT for liver tumors. SBRT is a potential game changer for multimodal therapy.

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Correlation of chemokines and growth factors with radiation-induced liver injury after interstitial high dose rate (HDR) brachytherapy of liver metastases

Damm

Pech

Cavalli

et al. 2022

J Cancer Res Clin Oncol

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Background Locoregional therapies, as imaging-guided tumor-directed procedures, are emerging treatment strategies in the management of primary and secondary liver malignancies such as e.g. colorectal cancer liver metastases. As one of those, irradiation-based interstitial high dose rate brachytherapy (iBT) of liver metastases bears a risk of developing focal radiation-induced liver injury (fRILI). Since little is known about biological factors involved in hepatic dysfunction after irradiation, the aim of this study was to identify factors, that may play a role in the underlying mechanism of fRILI, and that potentially may serve as biomarkers for post-therapeutic fRILI to improve specific management and treatment of patients. Methods Twenty-two patients with hepatic malignancies (tumor patients, TP) underwent iBT with total ablative doses of radiation to the target volume ranging from e.g. 15 to 25 Gy. Hepatobiliary magnetic resonance imaging (MRI) was performed 6 weeks after iBT to quanitify fRILI. Blood samples were taken before (pre) and 6 weeks after (post) iBT from TP, and from ten healthy volunteers (HV controls) for the analyses of humoral mediators: monocyte chemoattractant protein-1 (MCP-1), chemokine (C-X3-C motif) ligand 1 (CX3CL1), vascular endothelial growth factor (VEGF) and beta-nerve growth factor (beta-NGF) using the Multi-Analyte Flow Assay via flow cytometry. Correlation analyses between the humoral mediators (pre and post iBT) with the tumor volume and fRILI were performed. Results While MCP-1 and CX3CL1 tended to decrease in TP vs. HV, VEGF was significantly decreased in TP vs. HV pre and post iBT (p < 0.05). Beta-NGF levels were significantly increased in TP vs. HV pre and post iBT (p < 0.05). Baseline circulating levels of MCP-1, VEGF and beta-NGF have shown significant positive correlations with the hepatic tumor volume (p < 0.05). Circulating levels of humoral mediators before treatment did not correlate with fRILI, while CX3CL1 and VEGF after iBT have shown significant positive correlations with fRILI (p < 0.05). Conclusion Tumor volume and threshold dose of irradiation damage correlated positively with MCP-1 and VEGF as well as NGF and CX3CL, respectively. Thus, investigation of biological mediators in blood samples from tumor patients may provide an appropriate tool to predict fRILI after interstitial HDR brachytherapy of liver metastases.

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Validation of the liver mean dose in terms of the biological effective dose for the prevention of radiation-induced liver damage

Abstract: A mean BED of 73 and 16 Gy for the whole liver appeared appropriate to prevent RILD in patients with Child-Pugh classes A and B, respectively. The mean BED for the liver correlated well with the PTV.

Cited by 11 publications

References 34 publications

Preoperative Stereotactic Body Radiotherapy to Portal Vein Tumour Thrombus in Hepatocellular Carcinoma: Clinical and Pathological Analysis

Preoperative Stereotactic Body Radiotherapy to Portal Vein Tumour Thrombus in Hepatocellular Carcinoma: Clinical and Pathological Analysis

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

Correlation of chemokines and growth factors with radiation-induced liver injury after interstitial high dose rate (HDR) brachytherapy of liver metastases

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