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Selection of the optimal radiotherapy technique for locally advanced hepatocellular carcinoma

Authors
 Ik Jae Lee  ;  Jinsil Seong  ;  Woong Sub Koom  ;  Yong Bae Kim  ;  Byeong Chul Jeon  ;  Joo Ho Kim  ;  Kwang Hyub Han 
Citation
 JAPANESE JOURNAL OF CLINICAL ONCOLOGY, Vol.41(7) : 882-889, 2011 
Journal Title
JAPANESE JOURNAL OF CLINICAL ONCOLOGY
ISSN
 0368-2811 
Issue Date
2011
MeSH
Aged ; Carcinoma, Hepatocellular/pathology* ; Carcinoma, Hepatocellular/radiotherapy* ; Female ; Humans ; Liver Neoplasms/pathology* ; Liver Neoplasms/radiotherapy* ; Male ; Middle Aged ; Neoplasm Staging ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Computer-Assisted/methods* ; Radiotherapy, Conformal ; Radiotherapy, Intensity-Modulated ; Tomography, Spiral Computed ; Treatment Outcome
Keywords
hepatocellular carcinoma ; 3D-CRT ; IMRT ; helical tomotherapy
Abstract
OBJECTIVE: Various techniques are available for radiotherapy of hepatocellular carcinoma, including three-dimensional conformal radiotherapy, linac-based intensity-modulated radiotherapy and helical tomotherapy. The purpose of this study was to determine the optimal radiotherapy technique for hepatocellular carcinoma.

METHODS: Between 2006 and 2007, 12 patients underwent helical tomotherapy for locally advanced hepatocellular carcinoma. Helical tomotherapy computerized radiotherapy planning was compared with the best computerized radiotherapy planning for three-dimensional conformal radiotherapy and linac-based intensity-modulated radiotherapy for the delivery of 60 Gy in 30 fractions. Tumor coverage was assessed by conformity index, radical dose homogeneity index and moderated dose homogeneity index. Computerized radiotherapy planning was also compared according to the tumor location.

RESULTS: Tumor coverage was shown to be significantly superior with helical tomotherapy as assessed by conformity index and moderated dose homogeneity index (P= 0.002 and 0.03, respectively). Helical tomotherapy showed significantly lower irradiated liver volume at 40, 50 and 60 Gy (V40, V50 and V60, P= 0.04, 0.03 and 0.01, respectively). On the contrary, the dose-volume of three-dimensional conformal radiotherapy at V20 was significantly smaller than those of linac-based intensity-modulated radiotherapy and helical tomotherapy in the remaining liver (P= 0.03). Linac-based intensity-modulated radiotherapy showed better sparing of the stomach compared with helical tomotherapy in the case of separated lesions in both lobes (12.3 vs. 24.6 Gy). Helical tomotherapy showed the high dose-volume exposure to the left kidney due to helical delivery in the right lobe lesion.

CONCLUSIONS: Helical tomotherapy achieved the best tumor coverage of the remaining normal liver. However, helical tomotherapy showed much exposure to the remaining liver at the lower dose region and left kidney.
Files in This Item:
T201103216.pdf Download
DOI
10.1093/jjco/hyr053
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
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94055
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