The challenge of inoperable hepatocellular carcinoma (HCC): results of a single-institutional experience on stereotactic body radiation therapy (SBRT)

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Abstract

Objectives: To evaluate the feasibility and efficacy of stereotactic body radiation therapy (SBRT) in the treatment of hepatocellular carcinoma (HCC) unsuitable for standard loco-regional therapies. Materials and methods: Patients with 1–3 inoperable HCC lesions with diameter ≤6 cm were treated by SBRT. According to lesions size and liver function, two prescription regimens were adopted: 48–75 Gy in three fractions or 36–60 Gy in six fractions. SBRT was delivered using the volumetric modulated arc therapy technique with flattening filter-free photon beams. The primary end points of this study were in-field local control (LC) and toxicity. Secondary end points were overall survival (OS) and progression-free survival (PFS). Results: Forty-three patients with 63 HCC lesions were irradiated. All patients had Child–Turcotte–Pugh class A or B disease. Thirty lesions (48 %) were treated with 48–75 Gy in three consecutive fractions, and 33 (52 %) received 36–60 Gy in six fractions. Median follow-up was 8 months (range 3–43 months). Actuarial LC at 6, 12 and 24 months was 94.2 ± 3.3, 85.8 ± 5.5 and 64.4 ± 11.5 %, respectively. A biological equivalent dose (BED) >100 Gy and GTV size were significant prognostic factors for LC in univariate analysis (p 100 (p 

Original languageEnglish
Article number17
Pages (from-to)1301-1309
Number of pages9
JournalJournal of Cancer Research and Clinical Oncology
Volume141
Issue number7
DOIs
Publication statusPublished - Jul 22 2015

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Hepatocellular Carcinoma
Radiotherapy
Intensity-Modulated Radiotherapy
Photons
Disease-Free Survival
Prescriptions
Survival
Liver
Therapeutics

Keywords

  • Hepatocellular carcinoma
  • Liver
  • RapidArc
  • Stereotactic body radiation therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

@article{3c6f19dcd4184279ab3c14e93906f146,
title = "The challenge of inoperable hepatocellular carcinoma (HCC): results of a single-institutional experience on stereotactic body radiation therapy (SBRT)",
abstract = "Objectives: To evaluate the feasibility and efficacy of stereotactic body radiation therapy (SBRT) in the treatment of hepatocellular carcinoma (HCC) unsuitable for standard loco-regional therapies. Materials and methods: Patients with 1–3 inoperable HCC lesions with diameter ≤6 cm were treated by SBRT. According to lesions size and liver function, two prescription regimens were adopted: 48–75 Gy in three fractions or 36–60 Gy in six fractions. SBRT was delivered using the volumetric modulated arc therapy technique with flattening filter-free photon beams. The primary end points of this study were in-field local control (LC) and toxicity. Secondary end points were overall survival (OS) and progression-free survival (PFS). Results: Forty-three patients with 63 HCC lesions were irradiated. All patients had Child–Turcotte–Pugh class A or B disease. Thirty lesions (48 {\%}) were treated with 48–75 Gy in three consecutive fractions, and 33 (52 {\%}) received 36–60 Gy in six fractions. Median follow-up was 8 months (range 3–43 months). Actuarial LC at 6, 12 and 24 months was 94.2 ± 3.3, 85.8 ± 5.5 and 64.4 ± 11.5 {\%}, respectively. A biological equivalent dose (BED) >100 Gy and GTV size were significant prognostic factors for LC in univariate analysis (p 100 (p ",
keywords = "Hepatocellular carcinoma, Liver, RapidArc, Stereotactic body radiation therapy",
author = "Marta Scorsetti and Tiziana Comito and Luca Cozzi and Elena Clerici and Angelo Tozzi and Ciro Franzese and Pierina Navarria and Antonella Fogliata and Stefano Tomatis and Giuseppo D’Agostino and Cristina Iftode and Pietro Mancosu and Roberto Ceriani and Guido Torzilli",
year = "2015",
month = "7",
day = "22",
doi = "10.1007/s00432-015-1929-y",
language = "English",
volume = "141",
pages = "1301--1309",
journal = "Journal of Cancer Research and Clinical Oncology",
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TY - JOUR

T1 - The challenge of inoperable hepatocellular carcinoma (HCC)

T2 - results of a single-institutional experience on stereotactic body radiation therapy (SBRT)

AU - Scorsetti, Marta

AU - Comito, Tiziana

AU - Cozzi, Luca

AU - Clerici, Elena

AU - Tozzi, Angelo

AU - Franzese, Ciro

AU - Navarria, Pierina

AU - Fogliata, Antonella

AU - Tomatis, Stefano

AU - D’Agostino, Giuseppo

AU - Iftode, Cristina

AU - Mancosu, Pietro

AU - Ceriani, Roberto

AU - Torzilli, Guido

PY - 2015/7/22

Y1 - 2015/7/22

N2 - Objectives: To evaluate the feasibility and efficacy of stereotactic body radiation therapy (SBRT) in the treatment of hepatocellular carcinoma (HCC) unsuitable for standard loco-regional therapies. Materials and methods: Patients with 1–3 inoperable HCC lesions with diameter ≤6 cm were treated by SBRT. According to lesions size and liver function, two prescription regimens were adopted: 48–75 Gy in three fractions or 36–60 Gy in six fractions. SBRT was delivered using the volumetric modulated arc therapy technique with flattening filter-free photon beams. The primary end points of this study were in-field local control (LC) and toxicity. Secondary end points were overall survival (OS) and progression-free survival (PFS). Results: Forty-three patients with 63 HCC lesions were irradiated. All patients had Child–Turcotte–Pugh class A or B disease. Thirty lesions (48 %) were treated with 48–75 Gy in three consecutive fractions, and 33 (52 %) received 36–60 Gy in six fractions. Median follow-up was 8 months (range 3–43 months). Actuarial LC at 6, 12 and 24 months was 94.2 ± 3.3, 85.8 ± 5.5 and 64.4 ± 11.5 %, respectively. A biological equivalent dose (BED) >100 Gy and GTV size were significant prognostic factors for LC in univariate analysis (p 100 (p 

AB - Objectives: To evaluate the feasibility and efficacy of stereotactic body radiation therapy (SBRT) in the treatment of hepatocellular carcinoma (HCC) unsuitable for standard loco-regional therapies. Materials and methods: Patients with 1–3 inoperable HCC lesions with diameter ≤6 cm were treated by SBRT. According to lesions size and liver function, two prescription regimens were adopted: 48–75 Gy in three fractions or 36–60 Gy in six fractions. SBRT was delivered using the volumetric modulated arc therapy technique with flattening filter-free photon beams. The primary end points of this study were in-field local control (LC) and toxicity. Secondary end points were overall survival (OS) and progression-free survival (PFS). Results: Forty-three patients with 63 HCC lesions were irradiated. All patients had Child–Turcotte–Pugh class A or B disease. Thirty lesions (48 %) were treated with 48–75 Gy in three consecutive fractions, and 33 (52 %) received 36–60 Gy in six fractions. Median follow-up was 8 months (range 3–43 months). Actuarial LC at 6, 12 and 24 months was 94.2 ± 3.3, 85.8 ± 5.5 and 64.4 ± 11.5 %, respectively. A biological equivalent dose (BED) >100 Gy and GTV size were significant prognostic factors for LC in univariate analysis (p 100 (p 

KW - Hepatocellular carcinoma

KW - Liver

KW - RapidArc

KW - Stereotactic body radiation therapy

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U2 - 10.1007/s00432-015-1929-y

DO - 10.1007/s00432-015-1929-y

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C2 - 25644863

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VL - 141

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EP - 1309

JO - Journal of Cancer Research and Clinical Oncology

JF - Journal of Cancer Research and Clinical Oncology

SN - 0171-5216

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