Accelerated treatment using intensity‐modulated radiation therapy plus concurrent capecitabine for unresectable hepatocellular carcinoma

Abstract

In contrast to the desmosome‐containing epithelial and carcinoma cells, normal and malignantly transformed cells derived from mesenchymal tissues and tumors are connected only by adherens junctions (AJs) containing N‐cadherins and/or cadherin‐11, anchored in a cytoplasmic plaque assembled by α‐ and β‐catenin, plakoglobin, proteins p120 and p0071. Here, we report that the AJs of many malignantly transformed cell lines are characterized by the additional presence of plakophilin‐2 (Pkp2), a protein hitherto known only as a major component of desmosomal plaques, i.e., AJs of epithelia and carcinomatous cells. This massive acquisition of Pkp2 and its integration into AJ plaques of a large number of transformed cell lines is demonstrated with biochemical and immunolocalization techniques. Upregulation of Pkp2 and its integration into AJs has also been noted in some soft tissue tumors insitu and some highly proliferative colonies of cultured mesenchymal stem cells. As Pkp2 has recently been identified as a functionally important major regulatory organizer in AJs and related junctions in epithelial cells and cardiomyocytes, we hypothesize that the integration of Pkp2 into AJs of “soft tissue tumor” cells also can serve functions in the upregulation of proliferation, the promotion of malignant growth in general as well as the close‐packing of diverse kinds of cells and the metastatic behavior of such tumors. We propose to examine its presence in transformed mesenchymal cells and related tumors and to use it as an additional diagnostic criterion. © 2009 UICC

Stereotactic body radiotherapy (SBRT) with or without surgery for primary and metastatic liver tumors

“…Oral capecitabine is another promising radiosensitizing agent for concurrent combination with liver radiotherapy for larger unresectable HCC. 35 Median survival for patients with liver metastases in our study was 26.9 months compared to 20.5 months in the Intergroup trial. Better treatment outcome observed in our study can be explained in part by patient selection: only 12% of patients had metastases from unfavorable primary sites (lung, ovary, head & neck), 71% of patients were treated for metachronous metastases, and 62% patients did not have extrahepatic metastases at the time of SBRT.…”

Hypofractionated radiotheapy using helical tomotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis

“…A PR or SD by the RECIST was achieved in 15 of the 16 evaluable patients. The response of 8 patients who have PVTT was not evaluated separately [14]. Choi et al performed stereotactic body radiation therapy using Cyberknife in 9 HCC patients whose target volume was only PVTT.…”

The Optimal Selection of Radiotherapy Treatment for Hepatocellular Carcinoma

“…However, the superiority of these sophisticated technologies has not been proven in terms of survival benefits yet 48,83. Further clinical study in the radiation treatment of HCC is necessary to confirm its role in multidisciplinary management of HCC.…”