Selection of the optimal radiotherapy technique for locally advanced hepatocellular carcinoma

Ik Jae Lee, Jinsil Seong, Woong Sub Koom, Yong Bae Kim, Byeong Chul Jeon, Joo Ho Kim, Kwang Hyub Han

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: Various techniques are available for radiotherapy of hepatocellular carcinoma, including three-dimensional conformal radiotherapy, linac-based intensity-modulated radiotherapy and helical tomotherapy. The purpose of this study was to determine the optimal radiotherapy technique for hepatocellular carcinoma. Methods: Between 2006 and 2007, 12 patients underwent helical tomotherapy for locally advanced hepatocellular carcinoma. Helical tomotherapy computerized radiotherapy planning was compared with the best computerized radiotherapy planning for three-dimensional conformal radiotherapy and linac-based intensity-modulated radiotherapy for the delivery of 60 Gy in 30 fractions. Tumor coverage was assessed by conformity index, radical dose homogeneity index and moderated dose homogeneity index. Computerized radiotherapy planning was also compared according to the tumor location. Results: Tumor coverage was shown to be significantly superior with helical tomotherapy as assessed by conformity index and moderated dose homogeneity index (P = 0.002 and 0.03, respectively). Helical tomotherapy showed significantly lower irradiated liver volume at 40, 50 and 60 Gy (V40, V50 and V60, P = 0.04, 0.03 and 0.01, respectively). On the contrary, the dose-volume of three-dimensional conformal radiotherapy at V20 was significantly smaller than those of linac-based intensity-modulated radiotherapy and helical tomotherapy in the remaining liver (P = 0.03). Linac-based intensity-modulated radiotherapy showed better sparing of the stomach compared with helical tomotherapy in the case of separated lesions in both lobes (12.3 vs. 24.6 Gy). Helical tomotherapy showed the high dose-volume exposure to the left kidney due to helical delivery in the right lobe lesion. Conclusions: Helical tomotherapy achieved the best tumor coverage of the remaining normal liver. However, helical tomotherapy showed much exposure to the remaining liver at the lower dose region and left kidney.

Original languageEnglish
Article numberhyr053
Pages (from-to)882-889
Number of pages8
JournalJapanese Journal of Clinical Oncology
Volume41
Issue number7
DOIs
Publication statusPublished - 2011 Jul 1

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Intensity-Modulated Radiotherapy
Hepatocellular Carcinoma
Radiotherapy
Conformal Radiotherapy
Liver
Neoplasms
Kidney

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

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title = "Selection of the optimal radiotherapy technique for locally advanced hepatocellular carcinoma",
abstract = "Objective: Various techniques are available for radiotherapy of hepatocellular carcinoma, including three-dimensional conformal radiotherapy, linac-based intensity-modulated radiotherapy and helical tomotherapy. The purpose of this study was to determine the optimal radiotherapy technique for hepatocellular carcinoma. Methods: Between 2006 and 2007, 12 patients underwent helical tomotherapy for locally advanced hepatocellular carcinoma. Helical tomotherapy computerized radiotherapy planning was compared with the best computerized radiotherapy planning for three-dimensional conformal radiotherapy and linac-based intensity-modulated radiotherapy for the delivery of 60 Gy in 30 fractions. Tumor coverage was assessed by conformity index, radical dose homogeneity index and moderated dose homogeneity index. Computerized radiotherapy planning was also compared according to the tumor location. Results: Tumor coverage was shown to be significantly superior with helical tomotherapy as assessed by conformity index and moderated dose homogeneity index (P = 0.002 and 0.03, respectively). Helical tomotherapy showed significantly lower irradiated liver volume at 40, 50 and 60 Gy (V40, V50 and V60, P = 0.04, 0.03 and 0.01, respectively). On the contrary, the dose-volume of three-dimensional conformal radiotherapy at V20 was significantly smaller than those of linac-based intensity-modulated radiotherapy and helical tomotherapy in the remaining liver (P = 0.03). Linac-based intensity-modulated radiotherapy showed better sparing of the stomach compared with helical tomotherapy in the case of separated lesions in both lobes (12.3 vs. 24.6 Gy). Helical tomotherapy showed the high dose-volume exposure to the left kidney due to helical delivery in the right lobe lesion. Conclusions: Helical tomotherapy achieved the best tumor coverage of the remaining normal liver. However, helical tomotherapy showed much exposure to the remaining liver at the lower dose region and left kidney.",
author = "Lee, {Ik Jae} and Jinsil Seong and Koom, {Woong Sub} and Kim, {Yong Bae} and Jeon, {Byeong Chul} and Kim, {Joo Ho} and Han, {Kwang Hyub}",
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Selection of the optimal radiotherapy technique for locally advanced hepatocellular carcinoma. / Lee, Ik Jae; Seong, Jinsil; Koom, Woong Sub; Kim, Yong Bae; Jeon, Byeong Chul; Kim, Joo Ho; Han, Kwang Hyub.

In: Japanese Journal of Clinical Oncology, Vol. 41, No. 7, hyr053, 01.07.2011, p. 882-889.

Research output: Contribution to journalArticle

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T1 - Selection of the optimal radiotherapy technique for locally advanced hepatocellular carcinoma

AU - Lee, Ik Jae

AU - Seong, Jinsil

AU - Koom, Woong Sub

AU - Kim, Yong Bae

AU - Jeon, Byeong Chul

AU - Kim, Joo Ho

AU - Han, Kwang Hyub

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Objective: Various techniques are available for radiotherapy of hepatocellular carcinoma, including three-dimensional conformal radiotherapy, linac-based intensity-modulated radiotherapy and helical tomotherapy. The purpose of this study was to determine the optimal radiotherapy technique for hepatocellular carcinoma. Methods: Between 2006 and 2007, 12 patients underwent helical tomotherapy for locally advanced hepatocellular carcinoma. Helical tomotherapy computerized radiotherapy planning was compared with the best computerized radiotherapy planning for three-dimensional conformal radiotherapy and linac-based intensity-modulated radiotherapy for the delivery of 60 Gy in 30 fractions. Tumor coverage was assessed by conformity index, radical dose homogeneity index and moderated dose homogeneity index. Computerized radiotherapy planning was also compared according to the tumor location. Results: Tumor coverage was shown to be significantly superior with helical tomotherapy as assessed by conformity index and moderated dose homogeneity index (P = 0.002 and 0.03, respectively). Helical tomotherapy showed significantly lower irradiated liver volume at 40, 50 and 60 Gy (V40, V50 and V60, P = 0.04, 0.03 and 0.01, respectively). On the contrary, the dose-volume of three-dimensional conformal radiotherapy at V20 was significantly smaller than those of linac-based intensity-modulated radiotherapy and helical tomotherapy in the remaining liver (P = 0.03). Linac-based intensity-modulated radiotherapy showed better sparing of the stomach compared with helical tomotherapy in the case of separated lesions in both lobes (12.3 vs. 24.6 Gy). Helical tomotherapy showed the high dose-volume exposure to the left kidney due to helical delivery in the right lobe lesion. Conclusions: Helical tomotherapy achieved the best tumor coverage of the remaining normal liver. However, helical tomotherapy showed much exposure to the remaining liver at the lower dose region and left kidney.

AB - Objective: Various techniques are available for radiotherapy of hepatocellular carcinoma, including three-dimensional conformal radiotherapy, linac-based intensity-modulated radiotherapy and helical tomotherapy. The purpose of this study was to determine the optimal radiotherapy technique for hepatocellular carcinoma. Methods: Between 2006 and 2007, 12 patients underwent helical tomotherapy for locally advanced hepatocellular carcinoma. Helical tomotherapy computerized radiotherapy planning was compared with the best computerized radiotherapy planning for three-dimensional conformal radiotherapy and linac-based intensity-modulated radiotherapy for the delivery of 60 Gy in 30 fractions. Tumor coverage was assessed by conformity index, radical dose homogeneity index and moderated dose homogeneity index. Computerized radiotherapy planning was also compared according to the tumor location. Results: Tumor coverage was shown to be significantly superior with helical tomotherapy as assessed by conformity index and moderated dose homogeneity index (P = 0.002 and 0.03, respectively). Helical tomotherapy showed significantly lower irradiated liver volume at 40, 50 and 60 Gy (V40, V50 and V60, P = 0.04, 0.03 and 0.01, respectively). On the contrary, the dose-volume of three-dimensional conformal radiotherapy at V20 was significantly smaller than those of linac-based intensity-modulated radiotherapy and helical tomotherapy in the remaining liver (P = 0.03). Linac-based intensity-modulated radiotherapy showed better sparing of the stomach compared with helical tomotherapy in the case of separated lesions in both lobes (12.3 vs. 24.6 Gy). Helical tomotherapy showed the high dose-volume exposure to the left kidney due to helical delivery in the right lobe lesion. Conclusions: Helical tomotherapy achieved the best tumor coverage of the remaining normal liver. However, helical tomotherapy showed much exposure to the remaining liver at the lower dose region and left kidney.

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