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Journal of Radiation Oncology

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01-12-2017 | Original Research

Liver stereotactic radiotherapy (SRT) with functional treatment planning for patients with intermediate stage hepatocellular carcinoma (HCC)

Authors: Vijay Kudithipudi, Ellen Day, Ngoc Thai, Alexander Kirichenko

Published in: Journal of Radiation Oncology | Issue 4/2017

Abstract

Objective

The objective of this study was to analyze hepatic failure progression and survival in patients with Barcelona Clinic Liver Cancer (BCLC) A3-B hepatocellular carcinoma (HCC) after stereotactic radiotherapy (SRT) with functional treatment planning.

Methods

Liver SPECT was co-registered to 4DCT for avoidance of functional liver during SRT planning. Liver dose constraints/fractionation was based on functional liver volume. Concurrent capecitabine was administered for fraction size ≤ 4 Gy. Hepatic function, toxicity, and radiographic response were documented q4–6 months following radiotherapy.

Results

Twenty-two patients (14 Child-Pugh A, 8 Child-Pugh B Cirrhosis) with 39 lesions were analyzed. Fourteen patients received SBRT (mean dose 44.7 Gy, 5–6 fractions). Eight patients received SRT and concurrent capecitabine (mean dose 40.7 Gy, 14–18 fractions). Mean follow-up was 20 months. Nine patients developed grade ≤ 2 transient elevation of liver enzymes. At 24 months, Child-Pugh class was stable in 59% patients and MELD progression free survival was 76%. No RILD or accelerated hepatic failure was observed. In-field local control was 97.4% and overall survival was 59% at 2 years.

Conclusions

Liver SRT with functional treatment planning is safe in intermediate hepatocellular carcinoma. Liver failure is not hastened despite the inclusion of 36% Child-Pugh B patients.

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Title: Liver stereotactic radiotherapy (SRT) with functional treatment planning for patients with intermediate stage hepatocellular carcinoma (HCC)
Authors: Vijay Kudithipudi
Ellen Day
Ngoc Thai
Alexander Kirichenko
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: Journal of Radiation Oncology / Issue 4/2017
Print ISSN: 1948-7894
Electronic ISSN: 1948-7908
DOI: https://doi.org/10.1007/s13566-017-0325-4

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Abstract

Objective

Methods

Results

Conclusions

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