Is higher dose always the right answer in stereotactic body radiation therapy for small hepatocellular carcinoma?

Lee, Kyung Hwa; Yu, Jeong Il; Park, Hee Chul; Park, Suyeon; Shin, Jae Ho; Shin, Eunhyuk; Cho, Sungkoo; Jung, Sang Hoon; Han, Youngyih; Lim, Do Hoon

doi:10.3857/roj.2017.00598

Cited by 18 publications

(25 citation statements)

References 26 publications

(23 reference statements)

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“…Hepatocellular carcinoma (HCC), a malignant tumor that occurs from liver cells, is the most common primary liver cancer, which is a serious hazard to human health and is one of the few cancers with rising incidence in recent decades [1,2]. Radiotherapy is effective in the treatment of many malignant tumors, but HCC is resistant to radiation [3][4][5], and a strategy to increase its radiation sensitivity is needed.…”

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: The PI3K/mTOR dual inhibitor BEZ235 nanoparticles improve radiosensitization of hepatoma cells through apoptosis and regulation DNA repair pathway

Tang

Xie

et al. 2020

Nanoscale Res Lett

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Polymer materials encapsulating drugs have broad prospects for drug delivery. We evaluated the effectiveness of polyethylene glycol-poly (lactic-co-glycolic acid) (PLGA-PEG) encapsulation and release characteristics of PI3K/mTOR inhibitor NVP-BEZ235 (BEZ235). We proposed a strategy for targeting radiosensitization of liver cancer cells. The biocompatibility, cell interaction, and internalization of Glypican-3 (GPC3) antibody-modified, BEZ235-loaded PLGA-PEG nanoparticles (NP-BEZ235-Ab) in hepatoma cells in vitro were studied. Also, the cell killing effect of NP-BEZ235-Ab combined with γ-ray cell was evaluated. We used confocal microscopy to monitor nanoparticle-cell interactions and cellular uptake, conducted focus-formation experiments to analyze the synergistic biological effects of NP-BEZ235-Ab and priming, and studied synergy in liver cancer cells using molecular biological methods such as western blotting. We found that PLGA-PEG has good loading efficiency for BEZ235 and high selectivity to GPC3-positive HepG2 liver cancer cells, thus documenting that NP-BEZ235-Ab acts as a small-molecule drug delivery nanocarrier. At the nominal concentration, the NP-BEZ235-Ab nanoformulation synergistically kills liver cancer cells with significantly higher efficiency than does the free drug. Thus, NP-BEZ235-Ab is a potential radiosensitizer.

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Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: The PI3K/mTOR dual inhibitor BEZ235 nanoparticles improve radiosensitization of hepatoma cells through apoptosis and regulation DNA repair pathway

Tang

Xie

et al. 2020

Nanoscale Res Lett

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“…Hence, we decided to perform salvage therapies when typical recurrence was observed on regular follow-up images even if the lesion was small. As tumor size is one of the most important factors for local tumor control after SBRT, 8,10,[23][24][25] this may have led to the high local control rate in this study. Second, the established SBRT procedures and techniques at our institution, including 4D-CT, tumor localization on planning CT, respiratory-gated delivery, and a thorough image-guidance on each fraction, may have contributed to the improved clinical outcomes.…”

Section: Discussionmentioning

confidence: 87%

Stereotactic body radiation therapy for small (≤5 cm) hepatocellular carcinoma not amenable to curative treatment: Results of a single-arm, phase II clinical trial

Yoon¹,

Kim²,

Lim³

et al. 2020

Clin Mol Hepatol

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Background/Aims: Stereotactic body radiation therapy (SBRT) is used as an alternative ablative treatment in patients with hepatocellular carcinoma (HCC) not suitable for curative treatments. The purpose of this prospective study was to evaluate the long-term efficacy of SBRT for small (≤5 cm) HCCs.Methods: A phase II, single-arm clinical trial on SBRT for small HCCs was conducted at an academic tertiary care center. The planned SBRT dose was 45 Gy with a fraction size of 15-Gy over 3 consecutive days. The primary endpoint was 2-year local control rate. Radiologic responses were assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1) and the modified RECIST criteria.Results: Between 2013 and 2016, 50 patients (53 lesions) were enrolled, with a median follow-up period of 47.8 months (range, 2.9–70.6). Patients’ age ranged from 41 to 74 years, and 80% were male. Median tumor size was 1.3 cm (range, 0.7–3.1). The 2- and 5-year local control rates were 100% and 97.1%, respectively. The 5-year overall survival rate was 77.6%. Six months after SBRT, radiologic responses were evident in 44 lesions (83%) according to the RECIST criteria and 49 (92.4%) according to the modified RECIST criteria. None of the patients showed grade ≥3 adverse events.Conclusions: SBRT showed excellent results as an ablative treatment for patients with small HCCs while showing minimal toxicities. SBRT can be a good alternative for both curative and salvage intents in patients with HCCs that are unsuitable for curative treatments.

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“…Furthermore, SBRT can also be safely performed in patients with bleeding tendencies from background liver cirrhosis. Several prospective and retrospective studies have evaluated the ablative role and safety of SBRT for small HCCs and showed that SBRT results in an excellent local tumor control and minimal treatment‐related toxicity 5–19 …”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of stereotactic body radiation therapy for small hepatocellular carcinoma

Park

Jung

Cho

et al. 2020

J of Gastro and Hepatol

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Background and Aim The purpose of this study was to investigate the long‐term oncologic outcomes after stereotactic body radiation therapy (SBRT) for small hepatocellular carcinoma (HCC). Methods A total of 290 patients with HCC were registered between March 2007 and July 2013. A dose of 10–15 Gy per fraction was given over three to four consecutive days, resulting in a total dose of 30–60 Gy. Overall and recurrence‐free survivals were estimated from the date of the start of SBRT to the date of death, the last follow‐up examination, or to the date of tumor recurrence. Results The median follow‐up period of all patients was 38.2 months, and the median tumor size was 1.7 cm. Overall survival (OS) rate at 5 years was 44.9%. Multivariate analyses revealed that age, Child–Pugh class, tumor size, and albumin levels were significant factors for OS. The 5‐year local control rate was 91.3%. In multivariate analysis, tumor size and albumin were significantly associated with local tumor control. However, there was a negative correlation between total dose and tumor size in Pearson's correlation analysis (r = −0.111, P = 0.046). Conclusions Stereotactic body radiation therapy was an excellent ablative treatment option for patients with small HCC. Tumor size was a significant factor for local tumor control after SBRT, although the total dose was negatively correlated with tumor size. Considering the low OS rates and the high local tumor control rates, the combined SBRT and systemic therapies may be beneficial for improving survival outcomes.

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Is higher dose always the right answer in stereotactic body radiation therapy for small hepatocellular carcinoma?

Cited by 18 publications

References 26 publications

RETRACTED ARTICLE: The PI3K/mTOR dual inhibitor BEZ235 nanoparticles improve radiosensitization of hepatoma cells through apoptosis and regulation DNA repair pathway

RETRACTED ARTICLE: The PI3K/mTOR dual inhibitor BEZ235 nanoparticles improve radiosensitization of hepatoma cells through apoptosis and regulation DNA repair pathway

Stereotactic body radiation therapy for small (≤5 cm) hepatocellular carcinoma not amenable to curative treatment: Results of a single-arm, phase II clinical trial

Clinical outcomes of stereotactic body radiation therapy for small hepatocellular carcinoma

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