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Dose escalation in radiotherapy for incomplete transarterial chemoembolization of hepatocellular carcinoma

DC FieldValueLanguage
dc.contributor.author김도영-
dc.contributor.author변화경-
dc.contributor.author성진실-
dc.contributor.author한광협-
dc.date.accessioned2020-02-26T06:48:00Z-
dc.date.available2020-02-26T06:48:00Z-
dc.date.issued2020-
dc.identifier.issn0179-7158-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/175293-
dc.description.abstractPURPOSE: To investigate the efficacy of radiation dose escalation in patients with hepatocellular carcinoma (HCC) after incomplete transarterial chemoembolization (TACE). METHODS: This study evaluated retrospective data of 323 HCC patients who received radiotherapy after incomplete TACE from 2001-2016. Radiation dose in biologically effective dose (BED) (α/β = 10) was categorized as <72 Gy (261 patients) and ≥72 Gy (62 patients). Simultaneous integrated boost-intensity modulated radiation therapy (SIB-IMRT) was used significantly more frequently in the high-dose group (64.5% vs. 12.9%; P < 0.001). Local failure-free rate (LFFR), progression-free rate (PFR), and toxicities were compared between the two groups. Additionally, propensity score matching was performed. RESULTS: Median follow-up time for patients who were alive at the time of analysis was 47 months (range 18-189 months). Median overall survival after radiotherapy was 14 months. In multivariate analysis, BED ≥72 Gy was an independent predictor of favorable LFFR (hazard ratio [HR] 0.32; 95% confidence interval [CI] 0.14-0.72; P = 0.006) and PFR (HR 0.67; 95% CI 0.45-0.98; P = 0.04). In the propensity score-matched cohort (62 pairs), 1‑year LFFR (94% vs. 81%; P = 0.002), and 1‑year PFR (49% vs. 42%; P = 0.01) were significantly higher in the high-dose group. Treatment-related toxicities were comparable between the high-dose and low-dose groups (classic radiation-induced liver disease: 5.3% [3/57] vs. 13.8% [29/210], P = 0.08; grade 2-4 gastrointestinal bleeding: 3.2% [2/62] vs. 7.3% [19/261], P = 0.39). CONCLUSION: Radiation dose with BED ≥72 Gy improved LFFR and PFR without increasing toxicity. In radiotherapy for incomplete TACE of HCC, dose escalation using SIB-IMRT should be actively considered to improve oncologic outcome.-
dc.description.statementOfResponsibilityrestriction-
dc.languageGerman, English, French(Summary)-
dc.publisherUrban & Vogel-
dc.relation.isPartOfSTRAHLENTHERAPIE UND ONKOLOGIE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleDose escalation in radiotherapy for incomplete transarterial chemoembolization of 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.doi10.1007/s00066-019-01488-9-
dc.contributor.localIdA00385-
dc.contributor.localIdA05136-
dc.contributor.localIdA05136-
dc.contributor.localIdA01956-
dc.contributor.localIdA01956-
dc.contributor.localIdA04268-
dc.contributor.localIdA04268-
dc.relation.journalcodeJ02689-
dc.identifier.eissn1439-099X-
dc.identifier.pmid31286149-
dc.identifier.urlhttps://link.springer.com/article/10.1007%2Fs00066-019-01488-9-
dc.subject.keywordHepatocellular carcinoma-
dc.subject.keywordIntensity-modulated radiation therapy-
dc.subject.keywordRadiation dose escalation-
dc.subject.keywordRadiotherapy-
dc.subject.keywordTransarterial chemoembolization-
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.volume196-
dc.citation.number2-
dc.citation.startPage132-
dc.citation.endPage141-
dc.identifier.bibliographicCitationSTRAHLENTHERAPIE UND ONKOLOGIE, Vol.196(2) : 132-141, 2020-
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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