Improved oncologic outcomes with image-guided intensity-modulated radiation therapy using helical tomotherapy in locally advanced hepatocellular carcinoma

Hong In Yoon, Ik Jae Lee, Kwang Hyub Han, Jinsil Seong

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24 Citations (Scopus)

Abstract

Aim: To investigate whether image-guided intensity-modulated radiation therapy (IG-IMRT) improves survival in hepatocellular carcinoma (HCC) relative to 3-dimensional conformal radiotherapy (3D-CRT). Methods: Between 2006 and 2011, 187 HCC patients treated with definitive RT were reviewed. Median age was 53(range 51-83). All patients were stage III or IV-A. Concurrent chemoradiation was received by 178 patients (95.2 %). Overall actuarial survival (OS), progression-free survival (PFS), and infield-failure-free survival (IFFS) analyses were performed by Kaplan-Meier method. A Cox proportional hazards model was used for univariate and multivariate analysis. Pearson's chi-square test or Fisher's exact test was used to compare patient characteristics and treatment-related toxicity between the groups. Results: Sixty-five patients were treated with IG-IMRT and 122 patients with 3D-CRT. No significant differences were seen between the groups for all patient characteristics. IG-IMRT delivered higher doses than 3D-CRT (median biological effective dose 62.5 vs 53.1 Gy, P < 0.001). IG-IMRT showed significantly higher 3-year OS (33.4 vs 13.5 %, P < 0.001), PFS (11.1 vs 6.0 %, P = 0.004), and IFFS (46.8 vs 28.2 %, P = 0.007) than 3D-CRT. On univariate and multivariate analysis, RT modality was significant prognostic factor for OS (HR 2.18; 95 % CI 1.45-3.25; P < 0.001), PFS (HR 1.64; 95 % CI 1.17-2.29; P = 0.004). There was no significant difference between the two modalities for radiation-induced liver disease (P = 0.716). Conclusion: Our findings suggest that IG-IMRT could be an effective treatment that provides survival benefit without increasing severe toxicity in locally advanced HCC.

Original languageEnglish
Pages (from-to)1595-1605
Number of pages11
JournalJournal of cancer research and clinical oncology
Volume140
Issue number9
DOIs
Publication statusPublished - 2014 Sep

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Intensity-Modulated Radiotherapy
Hepatocellular Carcinoma
Radiotherapy
Conformal Radiotherapy
Survival
Disease-Free Survival
Multivariate Analysis
Chi-Square Distribution
Survival Analysis
Proportional Hazards Models
Liver Diseases
Radiation
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

@article{78318be7d56747a2bdf268d66d8a97ce,
title = "Improved oncologic outcomes with image-guided intensity-modulated radiation therapy using helical tomotherapy in locally advanced hepatocellular carcinoma",
abstract = "Aim: To investigate whether image-guided intensity-modulated radiation therapy (IG-IMRT) improves survival in hepatocellular carcinoma (HCC) relative to 3-dimensional conformal radiotherapy (3D-CRT). Methods: Between 2006 and 2011, 187 HCC patients treated with definitive RT were reviewed. Median age was 53(range 51-83). All patients were stage III or IV-A. Concurrent chemoradiation was received by 178 patients (95.2 {\%}). Overall actuarial survival (OS), progression-free survival (PFS), and infield-failure-free survival (IFFS) analyses were performed by Kaplan-Meier method. A Cox proportional hazards model was used for univariate and multivariate analysis. Pearson's chi-square test or Fisher's exact test was used to compare patient characteristics and treatment-related toxicity between the groups. Results: Sixty-five patients were treated with IG-IMRT and 122 patients with 3D-CRT. No significant differences were seen between the groups for all patient characteristics. IG-IMRT delivered higher doses than 3D-CRT (median biological effective dose 62.5 vs 53.1 Gy, P < 0.001). IG-IMRT showed significantly higher 3-year OS (33.4 vs 13.5 {\%}, P < 0.001), PFS (11.1 vs 6.0 {\%}, P = 0.004), and IFFS (46.8 vs 28.2 {\%}, P = 0.007) than 3D-CRT. On univariate and multivariate analysis, RT modality was significant prognostic factor for OS (HR 2.18; 95 {\%} CI 1.45-3.25; P < 0.001), PFS (HR 1.64; 95 {\%} CI 1.17-2.29; P = 0.004). There was no significant difference between the two modalities for radiation-induced liver disease (P = 0.716). Conclusion: Our findings suggest that IG-IMRT could be an effective treatment that provides survival benefit without increasing severe toxicity in locally advanced HCC.",
author = "Yoon, {Hong In} and Lee, {Ik Jae} and Han, {Kwang Hyub} and Jinsil Seong",
year = "2014",
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doi = "10.1007/s00432-014-1697-0",
language = "English",
volume = "140",
pages = "1595--1605",
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T1 - Improved oncologic outcomes with image-guided intensity-modulated radiation therapy using helical tomotherapy in locally advanced hepatocellular carcinoma

AU - Yoon, Hong In

AU - Lee, Ik Jae

AU - Han, Kwang Hyub

AU - Seong, Jinsil

PY - 2014/9

Y1 - 2014/9

N2 - Aim: To investigate whether image-guided intensity-modulated radiation therapy (IG-IMRT) improves survival in hepatocellular carcinoma (HCC) relative to 3-dimensional conformal radiotherapy (3D-CRT). Methods: Between 2006 and 2011, 187 HCC patients treated with definitive RT were reviewed. Median age was 53(range 51-83). All patients were stage III or IV-A. Concurrent chemoradiation was received by 178 patients (95.2 %). Overall actuarial survival (OS), progression-free survival (PFS), and infield-failure-free survival (IFFS) analyses were performed by Kaplan-Meier method. A Cox proportional hazards model was used for univariate and multivariate analysis. Pearson's chi-square test or Fisher's exact test was used to compare patient characteristics and treatment-related toxicity between the groups. Results: Sixty-five patients were treated with IG-IMRT and 122 patients with 3D-CRT. No significant differences were seen between the groups for all patient characteristics. IG-IMRT delivered higher doses than 3D-CRT (median biological effective dose 62.5 vs 53.1 Gy, P < 0.001). IG-IMRT showed significantly higher 3-year OS (33.4 vs 13.5 %, P < 0.001), PFS (11.1 vs 6.0 %, P = 0.004), and IFFS (46.8 vs 28.2 %, P = 0.007) than 3D-CRT. On univariate and multivariate analysis, RT modality was significant prognostic factor for OS (HR 2.18; 95 % CI 1.45-3.25; P < 0.001), PFS (HR 1.64; 95 % CI 1.17-2.29; P = 0.004). There was no significant difference between the two modalities for radiation-induced liver disease (P = 0.716). Conclusion: Our findings suggest that IG-IMRT could be an effective treatment that provides survival benefit without increasing severe toxicity in locally advanced HCC.

AB - Aim: To investigate whether image-guided intensity-modulated radiation therapy (IG-IMRT) improves survival in hepatocellular carcinoma (HCC) relative to 3-dimensional conformal radiotherapy (3D-CRT). Methods: Between 2006 and 2011, 187 HCC patients treated with definitive RT were reviewed. Median age was 53(range 51-83). All patients were stage III or IV-A. Concurrent chemoradiation was received by 178 patients (95.2 %). Overall actuarial survival (OS), progression-free survival (PFS), and infield-failure-free survival (IFFS) analyses were performed by Kaplan-Meier method. A Cox proportional hazards model was used for univariate and multivariate analysis. Pearson's chi-square test or Fisher's exact test was used to compare patient characteristics and treatment-related toxicity between the groups. Results: Sixty-five patients were treated with IG-IMRT and 122 patients with 3D-CRT. No significant differences were seen between the groups for all patient characteristics. IG-IMRT delivered higher doses than 3D-CRT (median biological effective dose 62.5 vs 53.1 Gy, P < 0.001). IG-IMRT showed significantly higher 3-year OS (33.4 vs 13.5 %, P < 0.001), PFS (11.1 vs 6.0 %, P = 0.004), and IFFS (46.8 vs 28.2 %, P = 0.007) than 3D-CRT. On univariate and multivariate analysis, RT modality was significant prognostic factor for OS (HR 2.18; 95 % CI 1.45-3.25; P < 0.001), PFS (HR 1.64; 95 % CI 1.17-2.29; P = 0.004). There was no significant difference between the two modalities for radiation-induced liver disease (P = 0.716). Conclusion: Our findings suggest that IG-IMRT could be an effective treatment that provides survival benefit without increasing severe toxicity in locally advanced HCC.

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