Whole-liver radiotherapy for end-stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunction
<p>Abstract</p> <p>Background</p> <p>To investigate whether whole-liver radiotherapy (RT) is beneficial in end-stage colorectal cancer with massive liver metastases and severe hepatic dysfunction.</p> <p>Methods</p> <p>Between June 2004 and July...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2010-10-01
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| Series: | Radiation Oncology |
| Online Access: | http://www.ro-journal.com/content/5/1/97 |
| _version_ | 1818556569436028928 |
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| author | Kim Sun Young Kim Tae Hyun Kim Dae Yong Yeo Seung-Gu Hong Yong Sang Jung Kyung Hae |
| author_facet | Kim Sun Young Kim Tae Hyun Kim Dae Yong Yeo Seung-Gu Hong Yong Sang Jung Kyung Hae |
| author_sort | Kim Sun Young |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>To investigate whether whole-liver radiotherapy (RT) is beneficial in end-stage colorectal cancer with massive liver metastases and severe hepatic dysfunction.</p> <p>Methods</p> <p>Between June 2004 and July 2008, 10 colorectal cancer patients, who exhibited a replacement of over three quarters of their normal liver by metastatic tumors and were of Child-Pugh class B or C in liver function with progressive disease after undergoing chemotherapy, underwent whole-liver RT. RT was administered using computed tomography-based three-dimensional planning and the median dose was 21 Gy (range, 21-30) in seven fractions. Improvement in liver function tests, defined as a decrease in the levels within 1 month after RT, symptom palliation, toxicity, and overall survival were analyzed retrospectively.</p> <p>Results</p> <p>Levels of alkaline phosphatase, total bilirubin, aspartate transaminase, and alanine transaminase improved in 8, 6, 9, and all 10 patients, respectively, and the median reduction rates were 42%, 68%, 50%, and 57%, respectively. Serum carcinoembryonic antigen level decreased after RT in three of four assessable patients. For all patients, pain levels decreased and acute toxicity consisted of nausea/vomiting of grade ≤ 2. Further chemotherapy became possible in four of 10 patients. Mean survival after RT was 80 ± 80 days (range, 20-289); mean survival for four patients who received post-RT chemotherapy was 143 ± 100 days (range, 65-289), versus 38 ± 16 days (range, 20-64) for the six patients who did not receive post-RT chemotherapy (<it>p </it>= 0.127).</p> <p>Conclusions</p> <p>Although limited by small case number, this study demonstrated a possible role of whole-liver RT in improving hepatic dysfunction and delaying mortality from hepatic failure for end-stage colorectal cancer patients with massive liver metastases. Further studies should be followed to confirm these findings.</p> |
| first_indexed | 2024-12-13T23:49:01Z |
| format | Article |
| id | doaj.art-16d03bb53bf04191b76c965c9370625f |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-13T23:49:01Z |
| publishDate | 2010-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-16d03bb53bf04191b76c965c9370625f2022-12-21T23:26:50ZengBMCRadiation Oncology1748-717X2010-10-01519710.1186/1748-717X-5-97Whole-liver radiotherapy for end-stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunctionKim Sun YoungKim Tae HyunKim Dae YongYeo Seung-GuHong Yong SangJung Kyung Hae<p>Abstract</p> <p>Background</p> <p>To investigate whether whole-liver radiotherapy (RT) is beneficial in end-stage colorectal cancer with massive liver metastases and severe hepatic dysfunction.</p> <p>Methods</p> <p>Between June 2004 and July 2008, 10 colorectal cancer patients, who exhibited a replacement of over three quarters of their normal liver by metastatic tumors and were of Child-Pugh class B or C in liver function with progressive disease after undergoing chemotherapy, underwent whole-liver RT. RT was administered using computed tomography-based three-dimensional planning and the median dose was 21 Gy (range, 21-30) in seven fractions. Improvement in liver function tests, defined as a decrease in the levels within 1 month after RT, symptom palliation, toxicity, and overall survival were analyzed retrospectively.</p> <p>Results</p> <p>Levels of alkaline phosphatase, total bilirubin, aspartate transaminase, and alanine transaminase improved in 8, 6, 9, and all 10 patients, respectively, and the median reduction rates were 42%, 68%, 50%, and 57%, respectively. Serum carcinoembryonic antigen level decreased after RT in three of four assessable patients. For all patients, pain levels decreased and acute toxicity consisted of nausea/vomiting of grade ≤ 2. Further chemotherapy became possible in four of 10 patients. Mean survival after RT was 80 ± 80 days (range, 20-289); mean survival for four patients who received post-RT chemotherapy was 143 ± 100 days (range, 65-289), versus 38 ± 16 days (range, 20-64) for the six patients who did not receive post-RT chemotherapy (<it>p </it>= 0.127).</p> <p>Conclusions</p> <p>Although limited by small case number, this study demonstrated a possible role of whole-liver RT in improving hepatic dysfunction and delaying mortality from hepatic failure for end-stage colorectal cancer patients with massive liver metastases. Further studies should be followed to confirm these findings.</p>http://www.ro-journal.com/content/5/1/97 |
| spellingShingle | Kim Sun Young Kim Tae Hyun Kim Dae Yong Yeo Seung-Gu Hong Yong Sang Jung Kyung Hae Whole-liver radiotherapy for end-stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunction Radiation Oncology |
| title | Whole-liver radiotherapy for end-stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunction |
| title_full | Whole-liver radiotherapy for end-stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunction |
| title_fullStr | Whole-liver radiotherapy for end-stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunction |
| title_full_unstemmed | Whole-liver radiotherapy for end-stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunction |
| title_short | Whole-liver radiotherapy for end-stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunction |
| title_sort | whole liver radiotherapy for end stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunction |
| url | http://www.ro-journal.com/content/5/1/97 |
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