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Stereotactic ablative radiotherapy in the treatment of hepatocellular carcinoma3 cm
- Source :
- Medical oncology (Northwood, London, England). 33(10)
- Publication Year :
- 2016
-
Abstract
- Stereotactic ablative radiotherapy (SABR) is a safe treatment approach for hepatocellular carcinoma (HCC) with comparable results to other local therapies. For lesions larger than 3 cm, no definitive standard treatment is present and several options are available. We retrospectively review local control (LC) and survival results of SABR in patients with HCC lesions >3 cm. Between 2012 and 2015, we treated 29 patients (39 lesions) having histological or radiological diagnosis of HCC and at least one lesion sized >3 cm. Patients were prescribed 36–48 Gy in 3–5 fractions (mainly 16 Gy × 3 fractions or 8 Gy × 5 fractions), in 3–5 consecutive days. A total of 15 lesions (52 %) had complete, while 10 (34 %) had partial remission; 3 (11 %) had a stable disease. Mean time for CR achievement was 5.8 months (range 1–17). One- and two-year actuarial LC was 100 %. Moreover, 1- and 2-year progression-free (PFS), cancer-specific and overall survival were 57.9 % [standard error (SE) 0.09; 95 % CI 36.9–74.2] and 41.2 % (SE 0.12; 95 % CI 17.7–63.5), 80.7 % (SE 0.08; 95 % CI 59.6–91.5) and 63.3 % (SE 0.11; 95 % CI 38.4–80.3), 71.7 % (SE 0.08; 95 % CI 51.2–84.7) and 56.2 % (SE 0.10; 95 % CI 33.8–73.6). On multivariate analysis, achieving a CR within the target lesion had a borderline significance with respect to PFS (HR 0.83; SE = 0.014; z −1.15; p = 0.095; 95 % CI 0.71–7.45). Time between HCC diagnosis and SABR delivery ( 12 months) was significantly correlated with OS (HR 16.5; SE 21.5; z = 2.14; p = 0.032; 95 % CI 1.27–213.3) as CLIP score (score: 0–1 vs 2) (HR 5.6; SE 4.6; z = 2.10; p = 0.036; 95 % CI 1.11–27.8). A total of 6 major toxic events (G3–G4) were recorded (20 %). In 2 patients (6 %), a radiation-induced liver disease was seen. In conclusion, SABR provided LC and survival rates comparable to other local therapies for patients with HCC lesion sized >3 cm, with acceptable toxicity profile.
- Subjects :
- Target lesion
Male
Cancer Research
medicine.medical_specialty
Carcinoma, Hepatocellular
Hepatocellular carcinoma
Radiofrequency ablation
Microwave
Radiation
Stereotactic ablative radiotherapy
TACE
Hematology
Oncology
medicine.medical_treatment
SABR volatility model
Radiosurgery
Gastroenterology
Disease-Free Survival
030218 nuclear medicine & medical imaging
law.invention
Lesion
03 medical and health sciences
Liver disease
0302 clinical medicine
law
Internal medicine
Medicine
Humans
Aged
Neoplasm Staging
Retrospective Studies
Aged, 80 and over
business.industry
Standard treatment
Radiotherapy Planning, Computer-Assisted
Liver Neoplasms
General Medicine
Middle Aged
medicine.disease
Radiation therapy
Survival Rate
030220 oncology & carcinogenesis
Female
medicine.symptom
business
Nuclear medicine
Subjects
Details
- ISSN :
- 1559131X
- Volume :
- 33
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Medical oncology (Northwood, London, England)
- Accession number :
- edsair.doi.dedup.....9e734ff77e10242e711a4d31b3105518