BMC Research Notes | |
Stereotactic Body radiation therapy for liver tumors with or without rotational intensity modulated radiation therapy | |
Philippe Maingon2  Jérôme Chamois2  Robin Garcia1  Laurent Mineur3  Magali Rouffiac-Thouant2  Magali Quivrin2  Adèle Cueff3  Gilles Créhange2  Elodie Nouhaud2  | |
[1] Department of Radiation Therapy, Sainte-Catherine Institute, Avignon, France;Department of Radiation Oncology and Surgical Oncology, Anticancer Centre Georges-François Leclerc, 21079 DIJON CEDEX, France;Biostatistics and epidemiological Unit, EA 4184, Anticancer Centre Georges-François Leclerc, Dijon, France | |
关键词: metastases; HCC; Radiotherapy; Liver; SBRT; | |
Others : 1140639 DOI : 10.1186/1756-0500-6-492 |
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received in 2013-02-12, accepted in 2013-11-22, 发布年份 2013 | |
【 摘 要 】
Background
To evaluate the feasibility and efficacy of Stereotactic body radiation therapy (SBRT) for primary liver lesions and liver metastases treated with linear accelerators with or without rotational Intensity Modulated RadioTherapy (IMRT).
Methods
Patients with either hepatocellular carcinoma, cholangiocarcinoma or metastatic liver lesions who had one to three lesions treated with SBRT in a single institution were retrospectively reviewed. Tumor response was evaluated according to EASL criteria 3 months after SBRT completion using MRI and/or abdominal CT scan. Responses were categorised as: Stable Disease (SD), Partial Response (PR), Complete Response (CR), Local Progression or Distant Progression in cases of new intra-hepatic lesions out-of-field or extra-hepatic metastases. Local Control (LC), Progression Free Survival (PFS), Overall Survival (OS) and treatment-related toxicities are reported.
Results
Between 2007 and 2012, 20 patients with a total of 24 lesions were treated with SBRT. Fourteen patients presented hepatocellular carcinoma (HCC), the others had either metastatic lesions from colorectal cancer (CRC) or cholangiocarcinoma. The median diameter of the lesions was 23 mm (5–98).
The dose per fraction ranged from 6 to 20 Gy with a median total dose of 60 Gy (range: 36–60 Gy). The dose was prescribed to the 80% isodose line covering the PTV.
The median follow-up was 24 months (15.7-29.7).
The actuarial LC rate was 78% for patients with HCC and 83% for those with adenocarcinoma and cholangiocarcinoma. Median OS was 37 months and OS rates were 83% at 12 and 24 months for HCC and 100% for adenocarcinoma. PFS was 54% for HCC and 50% for other types of tumors at 24 months.
Acute grade 3–4 toxicities occurred in 2 patients; a small proportion of the other patients experienced grade 1 or 2 toxicities.
Conclusions
SBRT provides excellent local control with minimal side effects in selected patients.
【 授权许可】
2013 Nouhaud et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150325070846320.pdf | 439KB | download | |
Figure 3. | 59KB | Image | download |
Figure 2. | 65KB | Image | download |
Figure 1. | 61KB | Image | download |
【 图 表 】
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Figure 3.
【 参考文献 】
- [1]Andolino DL, Johnson CS, Maluccio M, Kwo P, Tector AJ, Zook J, Johnstone PA, Cardenes HR: Stereotactic body radiotherapy for primary hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 2011, 81(4):c447-c453.
- [2]Tsai YC, Tsai CL, Hsu FM, Jian-Kuen W, Chien-Jang W, Cheng JC: Superior liver sparing by combined coplanar/noncoplanar volumetric-modulated arctherapy for hepatocellular carcinoma: a planning and feasibility study. Med Phys 2013, 38:366-371.
- [3]Timmerman RD, Kavanagh BD, Cho LC: Stereotactic body radiation therapy in multiple organ sites. J Clin Oncol 2007, 25(8):947-952.
- [4]Mac Dermed DM, Weichselbaum RR, Salama JK: A rationale for the targeted treatment of oligometastases with radiotherapy. J Surg Oncol 2008, 98:202-206.
- [5]Scorsetti M, Arcangeli S, Tozzi A, Comito T, Alongi F, Navarria P, Mancosu P, Reggiori G, Fogliata A, Torzilli G, Tomatis S, Cozzi L: Is stereotactic body radiation therapy an attractive option for resectable liver metastases? A preliminary report from a phase 2 trial. Int J Radiat Oncol Biol Phys 2013, 86(2):336-342.
- [6]Kavanagh BD, Shefter TE, Cardenes HR, Stieber VW, Raben D, Timmerman RD, McCarter MD, Burri S, Nedzi LA, Sawyer TE, Gaspar LE: Interim analysis of a prospective phase I/II trial of SBRT for liver metastases. Acta Oncol 2006, 45(7):848-855.
- [7]Hoyer M, Roed H, Traberg Hansen A, Ohlhuis L, Petersen J, Nellemann H, Kiil Berthelsen A, Grau C, Aage Engelholm S, Von der Maase H: Phase II study on stereotactic body radiotherapy of colorectal metastases. Acta Oncol 2006, 45(7):828-830.
- [8]Feng M, Ben-Josef E: Radiation therapy for hepatocellular carcinoma. Semin Radiat Oncol 2011, 21:271-277.
- [9]Rusthoven KE, Kavanagh BD, Cardenes H, Stieber VW, Burri SH, Feigenberg SJ, Chidel MA, Pugh TJ, Franklin W, Kane M, Gaspar LE, Schefter TE: Multi-institutional phase I/II trial of SBRT for liver metastases. J Clin Oncol 2009, 27:1572-1578.
- [10]Herfarth KK, Debus J, Lohr F, Bahner ML, Rhein B, Fritz P, Höss A, Schlegel W, Wannenmacher MF: Stereotactic single dose radiation therapy for liver tumors: results of a phase I/II trial. J Clin Oncol 2001, 19:164-170.
- [11]Eccles C, Brock KK, Bissonnette JP, Hawkins M, Dawson LA: Reproducibility of liver position using active breathing coordinator for liver cancer radiotherapy. Int J Radiat Oncol Biol Phys 2006, 64:751-759.
- [12]Case RB, Sonke J, Moseley DJ, Kim J, Brock KK, Dawson LA: Inter- and intrafraction variability in liver position in non-breath-hold stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 2009, 75(1):302-308.
- [13]Ong C, Verbakel WF, Cuijpers JP, Slotman BJ, Senan S: Dosimetric impact of interplay effect on Rapidarc lung stereotactic treatment delivery. Int J Radiat Oncol Biol Phys 2011, 79(1):305-311.
- [14]Court L, Wagar M, Berbeco R, Reisner A, Winey B, Schofield D, Ionascu D, Allen AM, Popple R, Lingos T, et al.: Evaluation of the interplay effect when using RapidArc to treat targets moving in the craniocaudal or right-left direction. Med Phys 2010, 37:4-11.
- [15]Tse RV, Hawkins M, Lockwood G, Kim JJ, Cummings B, Knox J, Sherman M, Dawson LA: Phase I study of individualized stereotactic body radiation therapy for hepatocellular carcinoma and intrahepatic cholangiocarcinoma. J Clin Oncol 2008, 26:657-664.
- [16]Sawrie SM, Fiveash JB, Caudell JJ: Stereotactic body radiation therapy for liver metastases and primary hepatocellular carcinoma: normal tissue tolerance and toxicity. Cancer Control 2010, 17(2):111-119.
- [17]Mendez Romero A, Wunderink W, Hussain SM, De Pooter JA, Heijmen BJ, Nowak PC, Nuyttens JJ, Brandwijk RP, Verhoef C, Ijzermans JN, Levendag PC: Stereotactic boby radiation therapy for primary and metastatic liver tumors: a single institution phase I-II study. Acta Oncol 2006, 45(7):831-837.
- [18]Shefter TE, Kavanagh BD, Timmerman RD, Cardenes HR, Baron A, Gaspar LE: A phase I trial of stereotactic body radiation therapy for liver metastases. Int J Radiat Oncol Biol Phy 2005, 62(5):1371-1378.
- [19]Dawson LA, Normolle D, Balter JM, McGinn CJ, Lawrence TS, Ten Haken RK: Analysis of radiation-induced liver disease using the NTCP model. Int J Radiat Oncol Biol Phys 2002, 53(4):810-821.
- [20]Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, Christensen E, Pagliaro L, Colombo M, Rodés J: EASL Panel of Experts on HCC. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL Conference. J Hepatol 2001, 35:421-430.
- [21]Forner A, Ayuso C, Varela M, Rimola J, Hessheimer AJ, de Lope CR, Reig M, Bianchi L, Llovet JM, Bruix J: Evaluation of tumor response after locoregional therapies in hepatocellular carcinoma. Are response evaluation criteria in solid tumors reliable? Cancer 2009, 115(3):616-623.
- [22]Price TR, Perkins SM, Sandrasegaran K, Henderson MA, Maluccio MA, Zook JE, Tector AJ, Vianna RM, Johnstone PA, Cardenes HR: Evaluation of response after stereotactic body radiotherapy for hepatocellular carcinoma. Cancer 2012, 15:3191-3198.
- [23]Lock MI, Hoyer M, Bydder SA, Okunieff P, Hahn CA, Vichare A, Dawson LA: An international survey on liver metastases radiotherapy. Acta Oncol 2012, 51(5):568-574.