期刊论文详细信息
Radiation Oncology
Feasibility of stereotactic body radiation therapy with volumetric modulated arc therapy and high intensity photon beams for hepatocellular carcinoma patients
Luca Cozzi4  Marta Scorsetti1  Antonella Fogliata4  Chin-Jyh Jang3  Feng-Ling Chang3  Na-Na Chung3  Wei-Chung Hsu2  Po-Ming Wang3 
[1] Istituto Clinico Humanitas, Rozzano, Italy;Department of Healthcare Administration, Asia University, Taichung, Taiwan;Department of Radiation Oncology, Chung-Kang branch, Cheng-Ching General Hospital, Taichung, Taiwan;Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
关键词: Flattening filter free beams;    SBRT;    VMAT;    RapidArc;    Hepatocelluar carcinoma;   
Others  :  815057
DOI  :  10.1186/1748-717X-9-18
 received in 2013-10-16, accepted in 2013-12-21,  发布年份 2014
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【 摘 要 】

Background

To report technical features, early outcome and toxicity of stereotactic body radiation therapy (SBRT) treatments with volumetric modulated arc therapy (RapidArc) for patients with hepatocellular carcinoma (HCC).

Methods

Twenty patients (22 lesions) were prospectively enrolled in a feasibility study. Dose prescription was 50Gy in 10 fractions. Seven patients (35%) were classified as AJCC stage I-II while 13 (65%) were stages III-IV. Eighteen patients (90%) were Child-Pugh stage A, the remaining were stage B. All patients were treated with RapidArc technique with flattening filter free (FFF) photon beams of 10MV from a TrueBeam linear accelerator. Technical, dosimetric and early clinical assessment was performed to characterize treatment and its potential outcome.

Results

Median age was 68 years, median initial tumor volume was 124 cm3 (range: 6–848). Median follow-up time was 7.4 months (range: 3–13). All patients completed treatment without interruption. Mean actuarial overall survival was of 9.6 ± 0.9 months (95%C.L. 7.8-11.4), median survival was not reached; complete response was observed in 8/22 (36.4%) lesions; partial response in 7/22 (31.8%), stable disease in 6/22 (27.3%), 1/22 (4.4%) showed progression. Toxicity was mild with only 1 case of grade 3 RILD and all other types were not greater than grade 2. Concerning dosimetric data, Paddick conformity index was 0.98 ± 0.02; gradient index was 3.82 ± 0.93; V95% to the clinical target volume was 93.6 ± 7.7%. Mean dose to kidneys resulted lower than 3.0Gy; mean dose to stomach 4.5 ± 3.0Gy; D1cm3 to spinal cord was 8.2 ± 4.5Gy; D1% to the esophagus was 10.2 ± 9.7Gy. Average beam on time resulted 0.7 ± 0.2 minutes (range: 0.4-1.4) with the delivery of an average of 4.4 partial arcs (range: 3–6) of those 86% non-coplanar.

Conclusions

Clinical results could suggest to introduce VMAT-RapidArc as an appropriate SBRT technique for patients with HCC in view of a prospective dose escalation trial.

【 授权许可】

   
2014 Wang et al.; licensee BioMed Central Ltd.

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