Effect of the normal liver mean dose on intrahepatic recurrence in patients with hepatocellular carcinoma after receiving liver stereotactic body radiation therapy

Background and purpose: This study aims to evaluate whether dosimetric parameters affect the intrahepatic out-field recurrence or distant metastasis-free survival following the stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma (HCC). Materials and methods: A total...

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Main Authors: Qi-Qiao Wu, Yi-Xing Chen, Shi-Suo Du, Yong Hu, Ping Yang, Jing Sun, Xin-Yue Wang, Wei-Xun Wu, Shu-Min Zhang, Zhao-Chong Zeng
Format: Article
Language:English
Published: Elsevier 2022-11-01
Series:Translational Oncology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1936523322001516
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author Qi-Qiao Wu
Yi-Xing Chen
Shi-Suo Du
Yong Hu
Ping Yang
Jing Sun
Xin-Yue Wang
Wei-Xun Wu
Shu-Min Zhang
Zhao-Chong Zeng
author_facet Qi-Qiao Wu
Yi-Xing Chen
Shi-Suo Du
Yong Hu
Ping Yang
Jing Sun
Xin-Yue Wang
Wei-Xun Wu
Shu-Min Zhang
Zhao-Chong Zeng
author_sort Qi-Qiao Wu
collection DOAJ
description Background and purpose: This study aims to evaluate whether dosimetric parameters affect the intrahepatic out-field recurrence or distant metastasis-free survival following the stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma (HCC). Materials and methods: A total of 76 patients with HCC who were treated with SBRT from January 2015 to May 2020 were included in this retrospective study. The main clinical endpoints considered were intrahepatic out-field free survival (OutFFS) and distant metastasis-free survival (DMFS). The target parameters and the liver were documented including tumor diameters, gross tumor volume (GTV), Liver minus GTV volume (LGV), and Liver minus GTV mean dose (LGD). Multivariable Cox regression with forward stepwise selection was performed to identify independent risk factors for OutFFS and DMFS. Maximally selected rank statistics were used to determine the most informative cut-off value for age and LGD. Results: The median follow-up was 28.2 months (range, 7.7–74.5 months). LGD higher than 12.54 Gy [HR, 0.861(0.747–0.993); p = 0.040] and age greater than 67-year-old [HR, 0.966(0.937–0.997); p = 0.030] are two independent predictors of OutFFS, previous TACE treatment [HR, 0.117(0.015–0.891); p = 0.038] was an independent predictor of DMFS. Conclusions: The results of this study suggested that the higher the dose received by the normal liver (greater than 12.54 Gy) the better the intrahepatic out-field recurrence-free survival (RFS) rate. Further study is warranted to confirm and to better understand this phenomenon.
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spelling doaj.art-9a236e308900471090955da208b6a9432022-12-22T04:00:21ZengElsevierTranslational Oncology1936-52332022-11-0125101492Effect of the normal liver mean dose on intrahepatic recurrence in patients with hepatocellular carcinoma after receiving liver stereotactic body radiation therapyQi-Qiao Wu0Yi-Xing Chen1Shi-Suo Du2Yong Hu3Ping Yang4Jing Sun5Xin-Yue Wang6Wei-Xun Wu7Shu-Min Zhang8Zhao-Chong Zeng9Radiation Oncology Department, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai, PR ChinaRadiation Oncology Department, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai, PR ChinaRadiation Oncology Department, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai, PR ChinaRadiation Oncology Department, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai, PR ChinaRadiation Oncology Department, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai, PR ChinaRadiation Oncology Department, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai, PR ChinaZhongshan Hospital, Fudan University (Xiamen Branch), PR ChinaZhongshan Hospital, Fudan University (Xiamen Branch), PR ChinaRadiation Oncology Department, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai, PR ChinaRadiation Oncology Department, Zhongshan Hospital, Fudan University, Fenglin Road 180, Shanghai, PR China; Corresponding author.Background and purpose: This study aims to evaluate whether dosimetric parameters affect the intrahepatic out-field recurrence or distant metastasis-free survival following the stereotactic body radiation therapy (SBRT) in patients with hepatocellular carcinoma (HCC). Materials and methods: A total of 76 patients with HCC who were treated with SBRT from January 2015 to May 2020 were included in this retrospective study. The main clinical endpoints considered were intrahepatic out-field free survival (OutFFS) and distant metastasis-free survival (DMFS). The target parameters and the liver were documented including tumor diameters, gross tumor volume (GTV), Liver minus GTV volume (LGV), and Liver minus GTV mean dose (LGD). Multivariable Cox regression with forward stepwise selection was performed to identify independent risk factors for OutFFS and DMFS. Maximally selected rank statistics were used to determine the most informative cut-off value for age and LGD. Results: The median follow-up was 28.2 months (range, 7.7–74.5 months). LGD higher than 12.54 Gy [HR, 0.861(0.747–0.993); p = 0.040] and age greater than 67-year-old [HR, 0.966(0.937–0.997); p = 0.030] are two independent predictors of OutFFS, previous TACE treatment [HR, 0.117(0.015–0.891); p = 0.038] was an independent predictor of DMFS. Conclusions: The results of this study suggested that the higher the dose received by the normal liver (greater than 12.54 Gy) the better the intrahepatic out-field recurrence-free survival (RFS) rate. Further study is warranted to confirm and to better understand this phenomenon.http://www.sciencedirect.com/science/article/pii/S1936523322001516Hepatocellular carcinomaRadiation dosageHelical intensity-modulated radiotherapyStereotactic body radiotherapyMetastasis
spellingShingle Qi-Qiao Wu
Yi-Xing Chen
Shi-Suo Du
Yong Hu
Ping Yang
Jing Sun
Xin-Yue Wang
Wei-Xun Wu
Shu-Min Zhang
Zhao-Chong Zeng
Effect of the normal liver mean dose on intrahepatic recurrence in patients with hepatocellular carcinoma after receiving liver stereotactic body radiation therapy
Translational Oncology
Hepatocellular carcinoma
Radiation dosage
Helical intensity-modulated radiotherapy
Stereotactic body radiotherapy
Metastasis
title Effect of the normal liver mean dose on intrahepatic recurrence in patients with hepatocellular carcinoma after receiving liver stereotactic body radiation therapy
title_full Effect of the normal liver mean dose on intrahepatic recurrence in patients with hepatocellular carcinoma after receiving liver stereotactic body radiation therapy
title_fullStr Effect of the normal liver mean dose on intrahepatic recurrence in patients with hepatocellular carcinoma after receiving liver stereotactic body radiation therapy
title_full_unstemmed Effect of the normal liver mean dose on intrahepatic recurrence in patients with hepatocellular carcinoma after receiving liver stereotactic body radiation therapy
title_short Effect of the normal liver mean dose on intrahepatic recurrence in patients with hepatocellular carcinoma after receiving liver stereotactic body radiation therapy
title_sort effect of the normal liver mean dose on intrahepatic recurrence in patients with hepatocellular carcinoma after receiving liver stereotactic body radiation therapy
topic Hepatocellular carcinoma
Radiation dosage
Helical intensity-modulated radiotherapy
Stereotactic body radiotherapy
Metastasis
url http://www.sciencedirect.com/science/article/pii/S1936523322001516
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