Stereotactic body radiotherapy for primary hepatocellular carcinoma

David L. Andolino, Cynthia S. Johnson, Mary Maluccio, Paul Kwo, A. Joseph Tector, Jennifer Zook, Peter A.S. Johnstone, Higinia R. Cardenes

Research output: Contribution to journalArticle

248 Citations (Scopus)

Abstract

Purpose: To evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for the treatment of primary hepatocellular carcinoma (HCC). Methods and Materials: From 2005 to 2009, 60 patients with liver-confined HCC were treated with SBRT at the Indiana University Simon Cancer Center: 36 Child-Turcotte-Pugh (CTP) Class A and 24 CTP Class B. The median number of fractions, dose per fraction, and total dose, was 3, 14 Gy, and 44 Gy, respectively, for those with CTP Class A cirrhosis and 5, 8 Gy, and 40 Gy, respectively, for those with CTP Class B. Treatment was delivered via 6 to 12 beams and in nearly all cases was prescribed to the 80% isodose line. The records of all patients were reviewed, and treatment response was scored according to Response Evaluation Criteria in Solid Tumors v1.1. Toxicity was graded according to the Common Terminology Criteria for Adverse Events v4.0. Local control (LC), time to progression (TTP), progression-free survival (PFS), and overall survival (OS) were calculated according to the method of Kaplan and Meier. Results: The median follow-up time was 27 months, and the median tumor diameter was 3.2 cm. The 2-year LC, PFS, and OS were 90%, 48%, and 67%, respectively, with median TTP of 47.8 months. Subsequently, 23 patients underwent transplant, with a median time to transplant of 7 months. There were no ≥Grade 3 nonhematologic toxicities. Thirteen percent of patients experienced an increase in hematologic/hepatic dysfunction greater than 1 grade, and 20% experienced progression in CTP class within 3 months of treatment. Conclusions: SBRT is a safe, effective, noninvasive option for patients with HCC ≤6 cm. As such, SBRT should be considered when bridging to transplant or as definitive therapy for those ineligible for transplant.

Original languageEnglish (US)
Pages (from-to)e447-e453
JournalInternational Journal of Radiation Oncology Biology Physics
Volume81
Issue number4
DOIs
StatePublished - Nov 15 2011

Fingerprint

Radiosurgery
progressions
Hepatocellular Carcinoma
radiation therapy
cancer
Transplants
toxicity
Disease-Free Survival
grade
tumors
Therapeutics
dosage
terminology
Survival
Liver
liver
Terminology
therapy
Neoplasms
safety

Keywords

  • Hepatocellular carcinoma
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Andolino, D. L., Johnson, C. S., Maluccio, M., Kwo, P., Tector, A. J., Zook, J., ... Cardenes, H. R. (2011). Stereotactic body radiotherapy for primary hepatocellular carcinoma. International Journal of Radiation Oncology Biology Physics, 81(4), e447-e453. https://doi.org/10.1016/j.ijrobp.2011.04.011

Stereotactic body radiotherapy for primary hepatocellular carcinoma. / Andolino, David L.; Johnson, Cynthia S.; Maluccio, Mary; Kwo, Paul; Tector, A. Joseph; Zook, Jennifer; Johnstone, Peter A.S.; Cardenes, Higinia R.

In: International Journal of Radiation Oncology Biology Physics, Vol. 81, No. 4, 15.11.2011, p. e447-e453.

Research output: Contribution to journalArticle

Andolino, DL, Johnson, CS, Maluccio, M, Kwo, P, Tector, AJ, Zook, J, Johnstone, PAS & Cardenes, HR 2011, 'Stereotactic body radiotherapy for primary hepatocellular carcinoma', International Journal of Radiation Oncology Biology Physics, vol. 81, no. 4, pp. e447-e453. https://doi.org/10.1016/j.ijrobp.2011.04.011
Andolino, David L. ; Johnson, Cynthia S. ; Maluccio, Mary ; Kwo, Paul ; Tector, A. Joseph ; Zook, Jennifer ; Johnstone, Peter A.S. ; Cardenes, Higinia R. / Stereotactic body radiotherapy for primary hepatocellular carcinoma. In: International Journal of Radiation Oncology Biology Physics. 2011 ; Vol. 81, No. 4. pp. e447-e453.
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abstract = "Purpose: To evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for the treatment of primary hepatocellular carcinoma (HCC). Methods and Materials: From 2005 to 2009, 60 patients with liver-confined HCC were treated with SBRT at the Indiana University Simon Cancer Center: 36 Child-Turcotte-Pugh (CTP) Class A and 24 CTP Class B. The median number of fractions, dose per fraction, and total dose, was 3, 14 Gy, and 44 Gy, respectively, for those with CTP Class A cirrhosis and 5, 8 Gy, and 40 Gy, respectively, for those with CTP Class B. Treatment was delivered via 6 to 12 beams and in nearly all cases was prescribed to the 80{\%} isodose line. The records of all patients were reviewed, and treatment response was scored according to Response Evaluation Criteria in Solid Tumors v1.1. Toxicity was graded according to the Common Terminology Criteria for Adverse Events v4.0. Local control (LC), time to progression (TTP), progression-free survival (PFS), and overall survival (OS) were calculated according to the method of Kaplan and Meier. Results: The median follow-up time was 27 months, and the median tumor diameter was 3.2 cm. The 2-year LC, PFS, and OS were 90{\%}, 48{\%}, and 67{\%}, respectively, with median TTP of 47.8 months. Subsequently, 23 patients underwent transplant, with a median time to transplant of 7 months. There were no ≥Grade 3 nonhematologic toxicities. Thirteen percent of patients experienced an increase in hematologic/hepatic dysfunction greater than 1 grade, and 20{\%} experienced progression in CTP class within 3 months of treatment. Conclusions: SBRT is a safe, effective, noninvasive option for patients with HCC ≤6 cm. As such, SBRT should be considered when bridging to transplant or as definitive therapy for those ineligible for transplant.",
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