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A prospective phase 2 multicenter study for the efficacy of radiation therapy following incomplete transarterial chemoembolization in unresectable hepatocellular carcinoma.

Authors
 Chihwan Choi  ;  Woong Sub Koom  ;  Tae Hyun Kim  ;  Sang Min Yoon  ;  Jin Hee Kim  ;  Hyung Sik Lee  ;  Taek Keun Nam  ;  Jinsil Seong 
Citation
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.90(5) : 1051-1060, 2014 
Journal Title
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 
ISSN
 0360-3016 
Issue Date
2014
MeSH
Adult ; Aged ; Antineoplastic Agents/administration & dosage ; Carcinoma, Hepatocellular/drug therapy* ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/radiotherapy* ; Chemoembolization, Therapeutic/methods* ; Cisplatin/administration & dosage ; Disease-Free Survival ; Doxorubicin/administration & dosage ; Female ; Humans ; Iodized Oil/administration & dosage ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/radiotherapy* ; Male ; Middle Aged ; Prospective Studies ; Radiotherapy Dosage ; Radiotherapy, Conformal/adverse effects ; Radiotherapy, Conformal/methods* ; Sample Size ; Treatment Failure
Abstract
PURPOSE: The purpose of this study was to investigate the efficacy and toxicity of radiation therapy (RT) following incomplete transarterial chemoembolization (TACE) in unresectable hepatocellular carcinoma (HCC). METHODS AND MATERIALS: The study was designed as a prospective phase 2 multicenter trial. Patients with unresectable HCC, who had viable tumor after TACE of no more than 3 courses, were eligible. Three-dimensional conformal RT (3D-CRT) was added for HCC treatment with incomplete uptake of iodized oil, and the interval from TACE to RT was 4 to 6 weeks. The primary endpoint of this study was the tumor response after RT following incomplete TACE in unresectable HCC. Secondary endpoints were patterns of failure, progression-free survival (PFS), time to tumor progression (TTP), overall survival (OS) rates at 2 years, and treatment-associated toxicity. Survival was calculated from the start of RT. RESULTS: Between August 2008 and December 2010, 31 patients were enrolled. RT was delivered at a median dose of 54 Gy (range, 46-59.4 Gy) at 1.8 to 2 Gy per fraction. A best objective in-field response rate was achieved in 83.9% of patients, with complete response (CR) in 22.6% of patients and partial response in 61.3% of patients within 12 weeks post-RT. A best objective overall response rate was achieved in 64.5% of patients with CR in 19.4% of patients and PR in 45.1% of patients. The 2-year in-field PFS, PFS, TTP, and OS rates were 45.2%, 29.0%, 36.6%, and 61.3%, respectively. The Barcelona Clinic liver cancer stage was a significant independent prognostic factor for PFS (P=.023). Classic radiation-induced liver disease was not observed. There were no treatment-related deaths or hepatic failure. CONCLUSIONS: Early 3D-CRT following incomplete TACE is a safe and practical treatment option for patients with unresectable HCC.
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301614036931
DOI
10.1016/j.ijrobp.2014.08.011
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Choi, Chi Hwan(최치환)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138237
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