Phase I/II trial of helical IMRT-based stereotactic body radiotherapy for hepatocellular carcinoma

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Abstract

Background: To report the results of a phase I/II study of helical IMRT-based stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC). Methods: Eligibility included Child–Turcotte–Pugh class A or B, ≤3 lesions, and cumulative tumor diameter ≤6 cm. Dose was escalated from 36 Gy to 60 Gy delivered in 4 fractions. Grade ≥3 gastrointestinal toxicities (CTCAE v3.0) or radiation-induced liver disease defined dose-limiting toxicity (DLT). Results: Thirty-two patients were enrolled: seven in dose levels 1–2 (36–44 Gy) and 25 in levels 3–4 (42–60 Gy). Failures included 1 local, 14 outfield intrahepatic, 2 distant, 1 concurrent local and outfield, 1 concurrent outfield and distant, and 1 concurrent local, outfield, and distant. Nine had grade 3 hematologic toxicities and 5 had grade 2 hepatic toxicities; no patient experienced DLT. Two-year local control (LFFS), outfield intrahepatic control (OutFFS), and overall survival (OS) rates were 80.9%, 46.7%, and 81.3%, respectively. Dose levels 3–4 and pre-radiotherapy multi-segment recurrence were independent prognostic factors for LFFS and OutFFS, respectively. Two-year LFFS, OutFFS, and OS were significantly higher for patients who were treated with dose-levels 3/4 for tumor(s) involving single segment compared with the rest of the patients. Conclusions: Helical IMRT-based SBRT was safe and effective, and patients with multi-segment recurrences prior to SBRT need to be closely followed.

Original languageEnglish
Pages (from-to)445-451
Number of pages7
JournalDigestive and Liver Disease
Volume51
Issue number3
DOIs
Publication statusPublished - 2019 Mar

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Radiosurgery
Hepatocellular Carcinoma
Recurrence
Liver Diseases
Neoplasms
Radiotherapy
Survival Rate
Radiation
Survival
Liver

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

@article{485bff9179c947e7909b2fe99ebe4305,
title = "Phase I/II trial of helical IMRT-based stereotactic body radiotherapy for hepatocellular carcinoma",
abstract = "Background: To report the results of a phase I/II study of helical IMRT-based stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC). Methods: Eligibility included Child–Turcotte–Pugh class A or B, ≤3 lesions, and cumulative tumor diameter ≤6 cm. Dose was escalated from 36 Gy to 60 Gy delivered in 4 fractions. Grade ≥3 gastrointestinal toxicities (CTCAE v3.0) or radiation-induced liver disease defined dose-limiting toxicity (DLT). Results: Thirty-two patients were enrolled: seven in dose levels 1–2 (36–44 Gy) and 25 in levels 3–4 (42–60 Gy). Failures included 1 local, 14 outfield intrahepatic, 2 distant, 1 concurrent local and outfield, 1 concurrent outfield and distant, and 1 concurrent local, outfield, and distant. Nine had grade 3 hematologic toxicities and 5 had grade 2 hepatic toxicities; no patient experienced DLT. Two-year local control (LFFS), outfield intrahepatic control (OutFFS), and overall survival (OS) rates were 80.9{\%}, 46.7{\%}, and 81.3{\%}, respectively. Dose levels 3–4 and pre-radiotherapy multi-segment recurrence were independent prognostic factors for LFFS and OutFFS, respectively. Two-year LFFS, OutFFS, and OS were significantly higher for patients who were treated with dose-levels 3/4 for tumor(s) involving single segment compared with the rest of the patients. Conclusions: Helical IMRT-based SBRT was safe and effective, and patients with multi-segment recurrences prior to SBRT need to be closely followed.",
author = "Kim, {Jun Won} and Kim, {Do Young} and Han, {Kwang Hyub} and Jinsil Seong",
year = "2019",
month = "3",
doi = "10.1016/j.dld.2018.11.004",
language = "English",
volume = "51",
pages = "445--451",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier",
number = "3",

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TY - JOUR

T1 - Phase I/II trial of helical IMRT-based stereotactic body radiotherapy for hepatocellular carcinoma

AU - Kim, Jun Won

AU - Kim, Do Young

AU - Han, Kwang Hyub

AU - Seong, Jinsil

PY - 2019/3

Y1 - 2019/3

N2 - Background: To report the results of a phase I/II study of helical IMRT-based stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC). Methods: Eligibility included Child–Turcotte–Pugh class A or B, ≤3 lesions, and cumulative tumor diameter ≤6 cm. Dose was escalated from 36 Gy to 60 Gy delivered in 4 fractions. Grade ≥3 gastrointestinal toxicities (CTCAE v3.0) or radiation-induced liver disease defined dose-limiting toxicity (DLT). Results: Thirty-two patients were enrolled: seven in dose levels 1–2 (36–44 Gy) and 25 in levels 3–4 (42–60 Gy). Failures included 1 local, 14 outfield intrahepatic, 2 distant, 1 concurrent local and outfield, 1 concurrent outfield and distant, and 1 concurrent local, outfield, and distant. Nine had grade 3 hematologic toxicities and 5 had grade 2 hepatic toxicities; no patient experienced DLT. Two-year local control (LFFS), outfield intrahepatic control (OutFFS), and overall survival (OS) rates were 80.9%, 46.7%, and 81.3%, respectively. Dose levels 3–4 and pre-radiotherapy multi-segment recurrence were independent prognostic factors for LFFS and OutFFS, respectively. Two-year LFFS, OutFFS, and OS were significantly higher for patients who were treated with dose-levels 3/4 for tumor(s) involving single segment compared with the rest of the patients. Conclusions: Helical IMRT-based SBRT was safe and effective, and patients with multi-segment recurrences prior to SBRT need to be closely followed.

AB - Background: To report the results of a phase I/II study of helical IMRT-based stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC). Methods: Eligibility included Child–Turcotte–Pugh class A or B, ≤3 lesions, and cumulative tumor diameter ≤6 cm. Dose was escalated from 36 Gy to 60 Gy delivered in 4 fractions. Grade ≥3 gastrointestinal toxicities (CTCAE v3.0) or radiation-induced liver disease defined dose-limiting toxicity (DLT). Results: Thirty-two patients were enrolled: seven in dose levels 1–2 (36–44 Gy) and 25 in levels 3–4 (42–60 Gy). Failures included 1 local, 14 outfield intrahepatic, 2 distant, 1 concurrent local and outfield, 1 concurrent outfield and distant, and 1 concurrent local, outfield, and distant. Nine had grade 3 hematologic toxicities and 5 had grade 2 hepatic toxicities; no patient experienced DLT. Two-year local control (LFFS), outfield intrahepatic control (OutFFS), and overall survival (OS) rates were 80.9%, 46.7%, and 81.3%, respectively. Dose levels 3–4 and pre-radiotherapy multi-segment recurrence were independent prognostic factors for LFFS and OutFFS, respectively. Two-year LFFS, OutFFS, and OS were significantly higher for patients who were treated with dose-levels 3/4 for tumor(s) involving single segment compared with the rest of the patients. Conclusions: Helical IMRT-based SBRT was safe and effective, and patients with multi-segment recurrences prior to SBRT need to be closely followed.

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U2 - 10.1016/j.dld.2018.11.004

DO - 10.1016/j.dld.2018.11.004

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C2 - 30503296

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VL - 51

SP - 445

EP - 451

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 3

ER -