Stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma and oligometastatic liver disease
Abstract Background To report our experience with SBRT in primary and secondary liver tumors. Methods We retrospectively analysed 55 patients (70 lesions) with a median follow-up of 10 months (range 1–57) treated from 2011 to 2016. All patients had not been eligible for other local treatment options...
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| Format: | Article |
| Language: | English |
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BMC
2018-05-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-018-1048-4 |
| _version_ | 1828401490090262528 |
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| author | Sabine Gerum Christian Heinz Claus Belka Franziska Walter Philipp Paprottka Enrico N. De Toni Falk Roeder |
| author_facet | Sabine Gerum Christian Heinz Claus Belka Franziska Walter Philipp Paprottka Enrico N. De Toni Falk Roeder |
| author_sort | Sabine Gerum |
| collection | DOAJ |
| description | Abstract Background To report our experience with SBRT in primary and secondary liver tumors. Methods We retrospectively analysed 55 patients (70 lesions) with a median follow-up of 10 months (range 1–57) treated from 2011 to 2016. All patients had not been eligible for other local treatment options. Median age was 64 years and 64% were male. 27 patients (36 lesions) suffered from hepatocellular carcinoma (HCC, Child A:78%, Child B:18%, Child C:4%), 28 patients (34 lesions) had oligometastatic liver disease (MD). Treatment planning was based on 4D-CT usually after placement of fiducials. Dose and fractionation varied depending on localization and size, most commonly 3 × 12.5 Gy (prescribed to the surrounding 65%-isodose) in 56% and 5x8Gy (80% isodose) in 20% of the treated lesions. Results Local recurrence was observed in 7 patients (13%) and 8 lesions (11%), resulting in estimated 1- and 2-year local control rates (LC) of 91 and 74%. Estimated 1- and 2-year rates of Freedom from hepatic failure (FFHF) were 42 and 28%. Number of lesions was predictive for LC and FFHF in the entire cohort. Estimated 1- and 2-year overall survival (OS) was 76 and 57%. OS was significantly affected by number of treated lesions and performance status. In the HCC subgroup, pretreatment liver function and gender were also predictive for OS. Maximum acute non-hepatic toxicity was grade 1 in 16% and grade 2 in 10% of the patients. Three HCC patients (11%) developed marked deterioration of liver function (grade 3/4). Conclusions SBRT resulted in high local control and acceptable survival rates in patients with HCC or MD not amendable to other locally-ablative treatment options with limited toxicity. Care should be taken in HCC patients with Child B cirrhosis. |
| first_indexed | 2024-12-10T09:47:48Z |
| format | Article |
| id | doaj.art-875a37abca3847b2a5cb0a3bdbce3953 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-10T09:47:48Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-875a37abca3847b2a5cb0a3bdbce39532022-12-22T01:53:45ZengBMCRadiation Oncology1748-717X2018-05-011311910.1186/s13014-018-1048-4Stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma and oligometastatic liver diseaseSabine Gerum0Christian Heinz1Claus Belka2Franziska Walter3Philipp Paprottka4Enrico N. De Toni5Falk Roeder6Department of Radiation Oncology, University Hospital LMU MunichDepartment of Radiation Oncology, University Hospital LMU MunichDepartment of Radiation Oncology, University Hospital LMU MunichDepartment of Radiation Oncology, University Hospital LMU MunichDepartment of Radiology, University Hospital LMU MunichDepartment of Internal Medicine, University Hospital LMU MunichDepartment of Radiation Oncology, University Hospital LMU MunichAbstract Background To report our experience with SBRT in primary and secondary liver tumors. Methods We retrospectively analysed 55 patients (70 lesions) with a median follow-up of 10 months (range 1–57) treated from 2011 to 2016. All patients had not been eligible for other local treatment options. Median age was 64 years and 64% were male. 27 patients (36 lesions) suffered from hepatocellular carcinoma (HCC, Child A:78%, Child B:18%, Child C:4%), 28 patients (34 lesions) had oligometastatic liver disease (MD). Treatment planning was based on 4D-CT usually after placement of fiducials. Dose and fractionation varied depending on localization and size, most commonly 3 × 12.5 Gy (prescribed to the surrounding 65%-isodose) in 56% and 5x8Gy (80% isodose) in 20% of the treated lesions. Results Local recurrence was observed in 7 patients (13%) and 8 lesions (11%), resulting in estimated 1- and 2-year local control rates (LC) of 91 and 74%. Estimated 1- and 2-year rates of Freedom from hepatic failure (FFHF) were 42 and 28%. Number of lesions was predictive for LC and FFHF in the entire cohort. Estimated 1- and 2-year overall survival (OS) was 76 and 57%. OS was significantly affected by number of treated lesions and performance status. In the HCC subgroup, pretreatment liver function and gender were also predictive for OS. Maximum acute non-hepatic toxicity was grade 1 in 16% and grade 2 in 10% of the patients. Three HCC patients (11%) developed marked deterioration of liver function (grade 3/4). Conclusions SBRT resulted in high local control and acceptable survival rates in patients with HCC or MD not amendable to other locally-ablative treatment options with limited toxicity. Care should be taken in HCC patients with Child B cirrhosis.http://link.springer.com/article/10.1186/s13014-018-1048-4LiverHCCOligometastaticSBRT |
| spellingShingle | Sabine Gerum Christian Heinz Claus Belka Franziska Walter Philipp Paprottka Enrico N. De Toni Falk Roeder Stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma and oligometastatic liver disease Radiation Oncology Liver HCC Oligometastatic SBRT |
| title | Stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma and oligometastatic liver disease |
| title_full | Stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma and oligometastatic liver disease |
| title_fullStr | Stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma and oligometastatic liver disease |
| title_full_unstemmed | Stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma and oligometastatic liver disease |
| title_short | Stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma and oligometastatic liver disease |
| title_sort | stereotactic body radiation therapy sbrt in patients with hepatocellular carcinoma and oligometastatic liver disease |
| topic | Liver HCC Oligometastatic SBRT |
| url | http://link.springer.com/article/10.1186/s13014-018-1048-4 |
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