TY - JOUR
T1 - Stereotactic body radiation therapy (SBRT) for definitive treatment and as a bridge to liver transplantation in early stage inoperable Hepatocellular carcinoma
AU - Moore, Assaf
AU - Cohen-Naftaly, Michal
AU - Tobar, Anna
AU - Kundel, Yulia
AU - Benjaminov, Ofer
AU - Braun, Marius
AU - Issachar, Assaf
AU - Mor, Eytan
AU - Sarfaty, Michal
AU - Bragilovski, Dimitri
AU - Hur, Ran Ben
AU - Gordon, Noa
AU - Stemmer, Salomon M.
AU - Allen, Aaron M.
N1 - Publisher Copyright:
© 2017 The Author(s).
PY - 2017/10/19
Y1 - 2017/10/19
N2 - Background and Purpose: Stereotactic body radiotherapy (SBRT) is an emerging modality for definitive treatment of Hepatocellular carcinoma (HCC). Materials and Methods: This retrospective study included all early stage HCC patients who were not candidates for primary resection and/or local therapy, treated with SBRT between 11/2011 and 1/2016. Results: Twenty-three patients were included. The median age was 62 years; 70% males; 30% females; 70% viral hepatitis carriers; 100% cirrhotic; 13 Child Pugh [CP]-A and 10 [CP]-B. The median tumor volume was 12.7cm3 (range, 2.2-53.6 cm3). Treatment was well tolerated. With the exception of one patient who developed RILD, no other patient had significant changes in 12 weeks of laboratory follow-up. SBRT was a bridge to transplantation in 16 patients and 11 were transplanted. No surgical difficulties or complications were reported following SBRT, and none of the transplanted patients had local progression before transplantation. The median prescribed dose to the tumor was 54Gy (range, 30-54Gy), the median dose to the uninvolved liver was 6.0Gy(range, 1.6-12.6Gy). With a median follow-up time of 12 months, the median overall-survival for the 11 transplanted patients was not reached (range, 2.0-53.7+ months) and was 23 months for the 12 non-transplanted patients. The median progression-free survival for the transplanted patients was not reached (54+ months) and was 14.0 months for the non-transplanted patients. There was no SBRT-related mortality. Liver explant post SBRT revealed pathological complete response in 3(27.3%), pathological partial response in 6(54.5%), and pathological stable disease in 2(18.2%) tumors. Conclusions: SBRT is safe and effective and can be used as a bridge to transplantation without comprising the surgical procedure.
AB - Background and Purpose: Stereotactic body radiotherapy (SBRT) is an emerging modality for definitive treatment of Hepatocellular carcinoma (HCC). Materials and Methods: This retrospective study included all early stage HCC patients who were not candidates for primary resection and/or local therapy, treated with SBRT between 11/2011 and 1/2016. Results: Twenty-three patients were included. The median age was 62 years; 70% males; 30% females; 70% viral hepatitis carriers; 100% cirrhotic; 13 Child Pugh [CP]-A and 10 [CP]-B. The median tumor volume was 12.7cm3 (range, 2.2-53.6 cm3). Treatment was well tolerated. With the exception of one patient who developed RILD, no other patient had significant changes in 12 weeks of laboratory follow-up. SBRT was a bridge to transplantation in 16 patients and 11 were transplanted. No surgical difficulties or complications were reported following SBRT, and none of the transplanted patients had local progression before transplantation. The median prescribed dose to the tumor was 54Gy (range, 30-54Gy), the median dose to the uninvolved liver was 6.0Gy(range, 1.6-12.6Gy). With a median follow-up time of 12 months, the median overall-survival for the 11 transplanted patients was not reached (range, 2.0-53.7+ months) and was 23 months for the 12 non-transplanted patients. The median progression-free survival for the transplanted patients was not reached (54+ months) and was 14.0 months for the non-transplanted patients. There was no SBRT-related mortality. Liver explant post SBRT revealed pathological complete response in 3(27.3%), pathological partial response in 6(54.5%), and pathological stable disease in 2(18.2%) tumors. Conclusions: SBRT is safe and effective and can be used as a bridge to transplantation without comprising the surgical procedure.
KW - Hepatocellular carcinoma (HCC)
KW - Liver transplantation
KW - Stereotactic body radiotherapy (SBRT)
UR - http://www.scopus.com/inward/record.url?scp=85031690871&partnerID=8YFLogxK
U2 - 10.1186/s13014-017-0899-4
DO - 10.1186/s13014-017-0899-4
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C2 - 29052532
AN - SCOPUS:85031690871
SN - 1748-717X
VL - 12
JO - Radiation Oncology
JF - Radiation Oncology
IS - 1
M1 - 163
ER -