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Phase I/II trial of helical IMRT-based stereotactic body radiotherapy for hepatocellular carcinoma

Authors
 Jun Won Kim  ;  Do Young Kim  ;  Kwang-Hyub Han  ;  Jinsil Seong 
Citation
 DIGESTIVE AND LIVER DISEASE, Vol.51(3) : 445-451, 2019 
Journal Title
 DIGESTIVE AND LIVER DISEASE 
ISSN
 1590-8658 
Issue Date
2019
Keywords
Helical intensity-modulated radiotherapy ; Hepatocellular carcinoma ; Phase I/II trial ; Stereotactic body radiotherapy
Abstract
BACKGROUND: To report the results of a phase I/II study of helical IMRT-based stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC). METHODS: Eligibility included Child-Turcotte-Pugh class A or B, ≤3 lesions, and cumulative tumor diameter ≤6 cm. Dose was escalated from 36 Gy to 60 Gy delivered in 4 fractions. Grade ≥3 gastrointestinal toxicities (CTCAE v3.0) or radiation-induced liver disease defined dose-limiting toxicity (DLT). RESULTS: Thirty-two patients were enrolled: seven in dose levels 1-2 (36-44 Gy) and 25 in levels 3-4 (42-60 Gy). Failures included 1 local, 14 outfield intrahepatic, 2 distant, 1 concurrent local and outfield, 1 concurrent outfield and distant, and 1 concurrent local, outfield, and distant. Nine had grade 3 hematologic toxicities and 5 had grade 2 hepatic toxicities; no patient experienced DLT. Two-year local control (LFFS), outfield intrahepatic control (OutFFS), and overall survival (OS) rates were 80.9%, 46.7%, and 81.3%, respectively. Dose levels 3-4 and pre-radiotherapy multi-segment recurrence were independent prognostic factors for LFFS and OutFFS, respectively. Two-year LFFS, OutFFS, and OS were significantly higher for patients who were treated with dose-levels 3/4 for tumor(s) involving single segment compared with the rest of the patients. CONCLUSIONS: Helical IMRT-based SBRT was safe and effective, and patients with multi-segment recurrences prior to SBRT need to be closely followed.
Full Text
https://www.sciencedirect.com/science/article/pii/S1590865818312234
DOI
10.1016/j.dld.2018.11.004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169894
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