Abstract
Background and aimsStereotactic body radiotherapy (SBRT) is a relatively new treatment for liver tumor. The outcomes of SBRT for liver tumor unfit for ablation and surgical resection were evaluated.MethodsLiver tumor patients treated with SBRT in seven Japanese institutions were studied retrospectively. Patients given SBRT for liver tumor between 2004 and 2012 were collected. Patients treated with SBRT preceded by trans-arterial chemoembolization (TACE) were eligible. Seventy-nine patients with hepatocellular carcinoma (HCC) and 51 patients with metastatic liver tumor were collected. The median biologically effective dose (BED) (α/β = 10 Gy) was 96.3 Gy for patients with HCC and 105.6 Gy with metastatic liver tumor.ResultsThe median follow-up time was 475.5 days in patients with HCC and 212.5 days with metastatic liver tumor. The 2-year local control rate (LCR) for HCC and metastatic liver tumor was 74.8% ± 6.3% and 64.2 ± 9.5% (p = 0.44). The LCR was not different between BED10 ≥ 100 Gy and < 100 Gy (p = 0.61). The LCR was significantly different between maximum tumor diameter > 30 mm vs. ≤ 30 mm (64% vs. 85%, p = 0.040) in all 130 patients. No grade 3 laboratory toxicities in the acute, sub-acute and chronic phases were observed.ConclusionsThere was no difference in local control after SBRT in the range of median BED10 around 100 Gy for between HCC and metastatic liver tumor. SBRT is safe and might be an alternative method to resection and ablation.SummaryThere was no difference in local control after SBRT in the range of median BED10 around 100 Gy for between HCC and metastatic liver tumor and SBRT is safe and might be an alternative method to resection and ablation.
Highlights
In Japan, an infection rate of the hepatitis C is high, and there are many hepatocellular carcinoma (HCC) cases
Summary: There was no difference in local control after stereotactic body radiotherapy (SBRT) in the range of median BED10 around 100 Gy for between HCC and metastatic liver tumor and SBRT is safe and might be an alternative method to resection and ablation
During follow-up of patients with liver disease, nodules ≥1 cm were diagnosed as HCC based on the typical hallmarks from imaging studies, which included a combination of contrast-enhanced ultrasonography, 4-phase multi-detector computed tomography (CT), dynamic contrast-enhanced magnetic resonance imaging (MRI), and CT during hepatic arteriography and arterio-portography studies
Summary
In Japan, an infection rate of the hepatitis C is high, and there are many hepatocellular carcinoma (HCC) cases. According to clinical practice guidelines from Japan, resection, radiofrequency ablation (RFA), and liver transplantation are the available curative options for HCC [1]. Stereotactic body radiotherapy (SBRT) has become a treatment option for patients some anatomic areas make the procedure difficult to perform [6]. It is only the case with a central lesion of the liver, with direct invasion into the vessels, and/or that an effect of TACE was insufficient to be introduced to SBRT. In patients with centrally located HCC with chronic hepatitis or cirrhosis, major resection is often contraindicated due to insufficient residual liver volume [7]. The outcomes of SBRT for liver tumor unfit for ablation and surgical resection were evaluated
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