Cancer Research and Treatment

Original Articles

Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B in Korea (KROG 16-05): Sun Hyun Bae, Hee Chul Park, Won Sup Yoon, Sang Min Yoon, In-Hye Jung, Ik Jae Lee, Jun Won Kim, Jinsil Seong, Tae Hyun Kim, Taek-Keun Nam, Youngmin Choi, Sun Young Lee, Hong Seok Jang, Dong Soo Lee, Jin Hee Kim; Cancer Res Treat. 2019;51(4):1589-1599. Published online April 10, 2019; DOI: https://doi.org/10.4143/crt.2018.687

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Purpose
There is limited data on radiotherapy (RT) for hepatocellular carcinoma (HCC) in patients with Child-Pugh classification B (CP-B). This study aimed to evaluate the treatment outcomes of fractionated conformal RT in HCC patients with CP-B.
Materials and Methods
We retrospectively reviewed the data of HCC patients with CP-B treated with RT between 2009 and 2014 at 13 institutions in Korea. HCC was diagnosed by the Korea guideline of 2009, and modern RT techniques were applied. Fraction size was ≤ 5 Gy and the biologically effective dose (BED) ≥ 40 Gy10 (α/β = 10 Gy). A total of 184 patients were included in this study.
Results
Initial CP score was seven in 62.0% of patients, eight in 31.0%, and nine in 7.0%. Portal vein tumor thrombosis was present in 66.3% of patients. The BED ranged from 40.4 to 89.6 Gy10 (median, 56.0 Gy10). After RT completion, 48.4% of patients underwent additional treatment. The median overall survival (OS) was 9.4 months. The local progression-free survival and OS rates at 1 year were 58.9% and 39.8%, respectively. In the multivariate analysis, non-classic radiation-induced liver disease (RILD) (p < 0.001) and additional treatment (p < 0.001) were the most significant prognostic factors of OS. Among 132 evaluable patients without progressive disease, 19.7% experienced non-classic RILD. Normal liver volume was the most predictive dosimetric parameter of non-classic RILD.
Conclusion
Fractionated conformal RT showed favorable OS with a moderate risk non-classic RILD. The individual radiotherapy for CP-B could be cautiously applied weighing the survival benefits and the RILD risks.

Citations

Citations to this article as recorded by

Development and validation of a nomogram for radiation-induced hepatic toxicity after intensity modulated radiotherapy for hepatocellular carcinoma: a retrospective study
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Japanese Journal of Clinical Oncology.2024; 54(6): 699. CrossRef
Managing hepatocellular carcinoma across the stages: efficacy and outcomes of stereotactic body radiotherapy
Ahmed Allam Mohamed, Marie-Luise Berres, Philipp Bruners, Sven Arke Lang, Christian Trautwein, Georg Wiltberger, Alexandra Barabasch, Michael Eble
Strahlentherapie und Onkologie.2024; 200(8): 715. CrossRef
Clinical outcomes and safety of external beam radiotherapy with extensive intrahepatic targets for advanced hepatocellular carcinoma: A single institutional clinical experience
Sunmin Park, Chai Hong Rim, Won Sup Yoon
Saudi Journal of Gastroenterology.2024;[Epub] CrossRef
Role of rapid arc-image-guided radiotherapy in hepatocellular carcinoma with portal vein tumor thrombosis: A study from tertiary care center in Punjab, India
Manjinder Singh Sidhu, Ramandeep, Sandhya Sood, Ritu Aggarwal, Kulbir Singh, Divyanshi Sood
Journal of Cancer Research and Therapeutics.2023; 19(3): 639. CrossRef
Non-classic radiation-induced liver disease after intensity-modulated radiotherapy for Child–Pugh grade B patients with locally advanced hepatocellular carcinoma
Jian-Xu Li, Rui-Jun Zhang, Mo-Qin Qiu, Liu-Ying Yan, Mei-Ling He, Mei-Ying Long, Jian-Hong Zhong, Hai-Yan Lu, Hong-Mei Zhou, Bang-De Xiang, Shi-Xiong Liang
Radiation Oncology.2023;[Epub] CrossRef
Long-term characterization of MRI-morphologic alterations after active motion-compensated liver SBRT: a multi-institutional pooled analysis
Constantin Dreher, Gustavo R. Sarria, Georgia Miebach, Christel Weiss, Daniel Buergy, Paulina Wojtal, Anoshirwan A. Tavakoli, David Krug, Hans Oppitz, Frank A. Giordano, Marcus Both, Frank Lohr, Jürgen Dunst, Oliver Blanck, Judit Boda-Heggemann
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A Survey of Stereotactic Body Radiotherapy in Korea: Sun Hyun Bae, Mi-Sook Kim, Won Il Jang, Chul-Seung Kay, Woochul Kim, Eun Seog Kim, Jin Ho Kim, Jin Hee Kim, Kwang Mo Yang, Kyu Chan Lee, A Ram Chang, Sunmi Jo; Cancer Res Treat. 2015;47(3):379-386. Published online November 24, 2014; DOI: https://doi.org/10.4143/crt.2014.021

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to investigate the current status of stereotactic body radiotherapy (SBRT) in Korea. A nationwide survey was conducted by the Korean Stereotactic Radiosurgery Group of the Korean Society for Radiation Oncology (KROG 13-13).
Materials and Methods
SBRT was defined as radiotherapy with delivery of a high dose of radiation to an extracranial lesion in ≤ 4 fractions. A 16-questionnaire survey was sent by e-mail to the chief of radiation oncology at 85 institutions in June 2013.
Results
All institutions (100%) responded to this survey. Of these, 38 institutions (45%) have used SBRT and 47 institutions (55%) have not used SBRT. Regarding the treatment site, the lung (92%) and liver (76%) were the two most common sites. The most common schedules were 60 Gy/4 fractions for non-small cell lung cancer, 48 Gy/4 fractions for lung metastases, 60 Gy/3 fractions for hepatocellular carcinoma, and 45 Gy/3 fractions or 40 Gy/4 fractions for liver metastases. Four-dimensional computed tomography (CT) was the most common method for planning CT (74%). During planning CT, the most common method of immobilization was the use of an alpha cradle/vacuum-lock (42%).
Conclusion
Based on this survey, conduct of further prospective studies will be needed in order to determine the appropriate prescribed doses and to standardize the practice of SBRT.

Citations

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