Helical tomotherapy for chemo‐refractory multiple liver metastases
Abstract Background Despite advances in chemotherapy, curing multiple liver metastases is quite rare. Even when response is obtained, regrowth of the tumors is almost inevitable. We aimed to evaluate the efficacy and adverse events of helical tomotherapy for chemo‐refractory multiple liver metastase...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-12-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.2651 |
| _version_ | 1818362970333249536 |
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| author | Taiki Takaoka Yuta Shibamoto Taro Murai Masanori Kobayashi Chikao Sugie Yoshihiko Manabe Takuhito Kondo Dai Okazaki Yuki Yamada Akira Torii |
| author_facet | Taiki Takaoka Yuta Shibamoto Taro Murai Masanori Kobayashi Chikao Sugie Yoshihiko Manabe Takuhito Kondo Dai Okazaki Yuki Yamada Akira Torii |
| author_sort | Taiki Takaoka |
| collection | DOAJ |
| description | Abstract Background Despite advances in chemotherapy, curing multiple liver metastases is quite rare. Even when response is obtained, regrowth of the tumors is almost inevitable. We aimed to evaluate the efficacy and adverse events of helical tomotherapy for chemo‐refractory multiple liver metastases. Methods Forty‐five patients with chemo‐refractory multiple (3‐10) liver metastases after standard systemic chemotherapy entered the single‐institutional prospective study. Liver metastases were the major disease; however, 31 also had uncontrolled primary lesions and/or other metastases. The prescribed dose was 55 Gy in 25 fractions. The median planning target volume (PTV) and normal liver volume (NLV) of first treatment were 128 cm3 and 1175 cm3, respectively. The median of V15Gy, V30Gy, and mean dose to NLV were 45%, 23%, and 19.4 Gy, respectively. Results Forty‐two patients (93%) completed the planned treatment. Median survival time (MST) for all patients was 8 months, and the 1‐year survival rate was 29%. The median local control (LC) period was 5 months and the 6‐month control rate of irradiated tumors was 33%. A ≥30% decrease in tumor markers was observed in 31%. The most common grade 3 toxicity was lymphocytopenia (40%), followed by fatigue (6%). Radiation‐induced liver disease (RILD) was not observed. Pancreatic cancer as the primary tumor, distant metastases outside the liver, low pretreatment neutrophil‐to‐lymphocyte ratio (NLR), and low pretreatment monocyte‐to‐lymphocyte ratio (MLR) were associated with poorer prognoses. Conclusions Helical tomotherapy for chemo‐refractory multiple liver metastases is a feasible and potentially effective treatment. Incorporating tomotherapy into the first‐line treatment in combination with systemic chemotherapy should be considered. Trial registration number CROG 12005. |
| first_indexed | 2024-12-13T21:41:02Z |
| format | Article |
| id | doaj.art-99f1855d626c4068abf97cd47bcb011d |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-13T21:41:02Z |
| publishDate | 2019-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-99f1855d626c4068abf97cd47bcb011d2022-12-21T23:30:32ZengWileyCancer Medicine2045-76342019-12-018187594760210.1002/cam4.2651Helical tomotherapy for chemo‐refractory multiple liver metastasesTaiki Takaoka0Yuta Shibamoto1Taro Murai2Masanori Kobayashi3Chikao Sugie4Yoshihiko Manabe5Takuhito Kondo6Dai Okazaki7Yuki Yamada8Akira Torii9Department of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Immunotherapy Seren Clinic Nagoya Nagoya JapanDepartment of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Radiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanAbstract Background Despite advances in chemotherapy, curing multiple liver metastases is quite rare. Even when response is obtained, regrowth of the tumors is almost inevitable. We aimed to evaluate the efficacy and adverse events of helical tomotherapy for chemo‐refractory multiple liver metastases. Methods Forty‐five patients with chemo‐refractory multiple (3‐10) liver metastases after standard systemic chemotherapy entered the single‐institutional prospective study. Liver metastases were the major disease; however, 31 also had uncontrolled primary lesions and/or other metastases. The prescribed dose was 55 Gy in 25 fractions. The median planning target volume (PTV) and normal liver volume (NLV) of first treatment were 128 cm3 and 1175 cm3, respectively. The median of V15Gy, V30Gy, and mean dose to NLV were 45%, 23%, and 19.4 Gy, respectively. Results Forty‐two patients (93%) completed the planned treatment. Median survival time (MST) for all patients was 8 months, and the 1‐year survival rate was 29%. The median local control (LC) period was 5 months and the 6‐month control rate of irradiated tumors was 33%. A ≥30% decrease in tumor markers was observed in 31%. The most common grade 3 toxicity was lymphocytopenia (40%), followed by fatigue (6%). Radiation‐induced liver disease (RILD) was not observed. Pancreatic cancer as the primary tumor, distant metastases outside the liver, low pretreatment neutrophil‐to‐lymphocyte ratio (NLR), and low pretreatment monocyte‐to‐lymphocyte ratio (MLR) were associated with poorer prognoses. Conclusions Helical tomotherapy for chemo‐refractory multiple liver metastases is a feasible and potentially effective treatment. Incorporating tomotherapy into the first‐line treatment in combination with systemic chemotherapy should be considered. Trial registration number CROG 12005.https://doi.org/10.1002/cam4.2651chemo‐refractorydendritic cell‐based vaccine therapyhelical tomotherapyintensity‐modulated radiation therapymultiple liver metastases |
| spellingShingle | Taiki Takaoka Yuta Shibamoto Taro Murai Masanori Kobayashi Chikao Sugie Yoshihiko Manabe Takuhito Kondo Dai Okazaki Yuki Yamada Akira Torii Helical tomotherapy for chemo‐refractory multiple liver metastases Cancer Medicine chemo‐refractory dendritic cell‐based vaccine therapy helical tomotherapy intensity‐modulated radiation therapy multiple liver metastases |
| title | Helical tomotherapy for chemo‐refractory multiple liver metastases |
| title_full | Helical tomotherapy for chemo‐refractory multiple liver metastases |
| title_fullStr | Helical tomotherapy for chemo‐refractory multiple liver metastases |
| title_full_unstemmed | Helical tomotherapy for chemo‐refractory multiple liver metastases |
| title_short | Helical tomotherapy for chemo‐refractory multiple liver metastases |
| title_sort | helical tomotherapy for chemo refractory multiple liver metastases |
| topic | chemo‐refractory dendritic cell‐based vaccine therapy helical tomotherapy intensity‐modulated radiation therapy multiple liver metastases |
| url | https://doi.org/10.1002/cam4.2651 |
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