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Dose escalation by intensity modulated radiotherapy in liver-directed concurrent chemoradiotherapy for locally advanced BCLC stage C hepatocellular carcinoma

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dc.contributor.author김도영-
dc.contributor.author변화경-
dc.contributor.author성진실-
dc.contributor.author한광협-
dc.date.accessioned2019-07-11T03:29:15Z-
dc.date.available2019-07-11T03:29:15Z-
dc.date.issued2019-
dc.identifier.issn0167-8140-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/169994-
dc.description.abstractPURPOSE: To evaluate the effects of dose escalation by intensity-modulated radiotherapy (IMRT) in liver-directed concurrent chemoradiotherapy for locally advanced Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma (BCLC-C HCC). MATERIALS AND METHODS: During 2005-2016, 637 patients with BCLC-C HCC received RT with concurrent hepatic arterial 5-fluorouracil. Patients were divided into two groups according to the biologically effective doses for a tumor (α/β = 10 Gy): <72 Gy (536 patients) and ≥72 Gy (101 patients). In each group, 128/536 (24%) and 94/101 patients (93%) used IMRT, respectively. RESULTS: The median follow-up for patients alive at the time of analysis was 36 months (range, 6-159 months). For ≥72 Gy and <72 Gy groups, the median overall survival (OS) was 21 and 13 months, respectively (P = .002). The 1-year local failure-free survival (LFFS) were significantly higher in high-dose group (95% vs. 79%; P < .001). After propensity score matching, high-dose group still had significantly better 1-year OS (62% vs. 51%; P = .03) and 1-year LFFS (95% vs. 78%; P = .008). In the multivariate model, RT dose was an independent predictor of LFFS and OS. The surgical conversion rate was significantly higher in high-dose group (20% vs. 12%, P = .03), with substantially increased median OS among patients who underwent surgery (104 months vs. 11 months; P < .001). There were no significant differences in gastrointestinal bleeding or radiation-induced liver disease. CONCLUSIONS: In liver-directed concurrent chemoradiotherapy, radiation dose escalation by IMRT increased LFFS and OS for locally advanced BCLC-C HCC. It also increased the conversion rate to curative resection, which was attributable to increased OS.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherElsevier Scientific Publishers-
dc.relation.isPartOfRADIOTHERAPY AND ONCOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleDose escalation by intensity modulated radiotherapy in liver-directed concurrent chemoradiotherapy for locally advanced BCLC stage C hepatocellular carcinoma-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorHwa Kyung Byun-
dc.contributor.googleauthorHyun Ju Kim-
dc.contributor.googleauthorYoo Ri Im-
dc.contributor.googleauthorDo Young Kim-
dc.contributor.googleauthorKwang-Hyub Han-
dc.contributor.googleauthorJinsil Seong-
dc.identifier.doi10.1016/j.radonc.2018.12.025-
dc.contributor.localIdA00385-
dc.contributor.localIdA05136-
dc.contributor.localIdA05136-
dc.contributor.localIdA01956-
dc.contributor.localIdA01956-
dc.contributor.localIdA04268-
dc.contributor.localIdA04268-
dc.relation.journalcodeJ02597-
dc.identifier.eissn1879-0887-
dc.identifier.pmid30935563-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S0167814018336697-
dc.subject.keywordHepatic arterial infusion chemotherapy-
dc.subject.keywordHepatocellular carcinoma-
dc.subject.keywordIntensity modulated radiotherapy-
dc.subject.keywordRadiation dose–response relationship-
dc.contributor.alternativeNameKim, Do Young-
dc.contributor.affiliatedAuthor김도영-
dc.contributor.affiliatedAuthor변화경-
dc.contributor.affiliatedAuthor변화경-
dc.contributor.affiliatedAuthor성진실-
dc.contributor.affiliatedAuthor성진실-
dc.contributor.affiliatedAuthor한광협-
dc.contributor.affiliatedAuthor한광협-
dc.citation.volume133-
dc.citation.startPage1-
dc.citation.endPage8-
dc.identifier.bibliographicCitationRADIOTHERAPY AND ONCOLOGY, Vol.133 : 1-8, 2019-
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

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