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Improved oncologic outcomes with image-guided intensity-modulated radiation therapy using helical tomotherapy in locally advanced hepatocellular carcinoma

Authors
 Hong In Yoon  ;  Ik Jae Lee  ;  Kwang-Hyub Han  ;  Jinsil Seong 
Citation
 JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, Vol.140(9) : 1595-1605, 2014 
Journal Title
 JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 
ISSN
 0171-5216 
Issue Date
2014
MeSH
Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/radiotherapy* ; Disease-Free Survival ; Female ; Humans ; Liver Neoplasms/mortality ; Liver Neoplasms/radiotherapy* ; Male ; Middle Aged ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Conformal/methods ; Radiotherapy, Image-Guided/methods ; Radiotherapy, Intensity-Modulated/methods
Keywords
Hepatocellular carcinoma ; Image-guided radiotherapy ; Intensity-modulated radiotherapy
Abstract
AIM: To investigate whether image-guided intensity-modulated radiation therapy (IG-IMRT) improves survival in hepatocellular carcinoma (HCC) relative to 3-dimensional conformal radiotherapy (3D-CRT). METHODS: Between 2006 and 2011, 187 HCC patients treated with definitive RT were reviewed. Median age was 53(range 51-83). All patients were stage III or IV-A. Concurrent chemoradiation was received by 178 patients (95.2 %). Overall actuarial survival (OS), progression-free survival (PFS), and infield-failure-free survival (IFFS) analyses were performed by Kaplan-Meier method. A Cox proportional hazards model was used for univariate and multivariate analysis. Pearson's chi-square test or Fisher's exact test was used to compare patient characteristics and treatment-related toxicity between the groups. RESULTS: Sixty-five patients were treated with IG-IMRT and 122 patients with 3D-CRT. No significant differences were seen between the groups for all patient characteristics. IG-IMRT delivered higher doses than 3D-CRT (median biological effective dose 62.5 vs 53.1 Gy, P < 0.001). IG-IMRT showed significantly higher 3-year OS (33.4 vs 13.5 %, P < 0.001), PFS (11.1 vs 6.0 %, P = 0.004), and IFFS (46.8 vs 28.2 %, P = 0.007) than 3D-CRT. On univariate and multivariate analysis, RT modality was significant prognostic factor for OS (HR 2.18; 95 % CI 1.45-3.25; P < 0.001), PFS (HR 1.64; 95 % CI 1.17-2.29; P = 0.004). There was no significant difference between the two modalities for radiation-induced liver disease (P = 0.716). CONCLUSION: Our findings suggest that IG-IMRT could be an effective treatment that provides survival benefit without increasing severe toxicity in locally advanced HCC.
Full Text
http://link.springer.com/article/10.1007%2Fs00432-014-1697-0
DOI
10.1007/s00432-014-1697-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
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/22282913/99431
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