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Plasma Cell-Free DNA as a Predictive Marker after Radiotherapy for Hepatocellular Carcinoma

 Sangjoon Park  ;  Eun Jung Lee  ;  Chai Hong Rim  ;  Jinsil Seong 
 YONSEI MEDICAL JOURNAL, Vol.59(4) : 470-479, 2018 
Journal Title
Issue Date
Adult ; Aged ; Tumor/*blood Biomarkers ; Hepatocellular/blood/genetics/pathology/*radiotherapy Carcinoma ; Cell-Free Nucleic Acids/*blood/*genetics ; Circulating Tumor DNA/*blood ; DNA ; Female ; Humans ; Liver Neoplasms/blood/genetics/pathology/*radiotherapy ; Male ; Middle Aged ; Portal Vein ; Prospective Studies ; Real-Time Polymerase Chain Reaction ; Treatment Outcome
Biomarkers ; cell-free DNA ; hepatocellular carcinoma ; radiotherapy ; treatment ; tumor
PURPOSE: Cell-free DNA (cfDNA) is gaining attention as a novel biomarker for oncologic outcomes. We investigated the clinical significance of cfDNA in hepatocellular carcinoma (HCC) patients treated with radiotherapy (RT). MATERIALS AND METHODS: Fifty-five patients with HCC who received RT were recruited from two prospective study cohorts: one cohort of 34 patients who underwent conventionally fractionated RT and a second of 21 patients treated with stereotactic body radiation therapy. cfDNA was extracted and quantified. RESULTS: In total, 30% of the patients had multiple tumors, 77% had tumors >2 cm, and 32% had portal vein tumor thrombus. Optimal cut-off values for cfDNA levels (33.65 ng/mL and 37.25 ng/mL, before and after RT) were used to divide patients into low-DNA (LDNA) and high-DNA (HDNA) groups. The pre-RT HDNA group tended to have more advanced disease and larger tumors (p=0.049 and p=0.017, respectively). Tumor response, intrahepatic failure-free rates, and local control (LC) rates were significantly better in the post-RT LDNA group (p=0.017, p=0.035, and p=0.006, respectively). CONCLUSION: Quantitative analysis of cfDNA was feasible in our cohorts. Post-RT cfDNA levels were negatively correlated with treatment outcomes, indicating the potential for the use of post-RT cfDNA levels as an early predictor of treatment responses and LC after RT for HCC patients.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
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