Brain Metastasis from Hepatocellular Carcinoma Treated with a Cyber-Knife

Hiraoka, Atsushi; Horiike, Norio; Tazuya, Nayu; Ichiryu, Misa; Nakahara, Hiromasa; Ochi, Hironori; Tanabe, Atsushi; Doi, Hiroyuki; Kodama, Akihiro; Hasebe, Aki; Ichikawa, Soichi; Miyamoto, Yoshinori; Nakamura, Tomoyuki; Asagi, Akinori; Matsubara, Hiroshi; Nadano, Seijin; Nishizaki, Osamu; Umeda, Masakichi

doi:10.2169/internalmedicine.47.1373

Cited by 11 publications

(15 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,5,16,17,21,22,25 ; WBRT, SRT (gammaknife, and cyber-knife) is recommended, even in advanced stages, to improve the general condition and neurologic symptoms due to the brain lesions 19 These treatments prevent rebleeding from the tumors, which is one of the key prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

“…Loco-regional treatment, including surgical resection, radiation therapy (e.g., whole brain radiation therapy (WBRT), stereotactic radiation therapy (SRT)), showed promising results in a few case studies. 4,7,17,[19][20][21][22] The efficacy of these treatment modalities is based on the control of tumor progression in the local area, improvement of neurologic symptoms, and maintenance of QOL. It is also noteworthy that controlling the intrahepatic lesions and providing supportive therapy for hepatic reserve function are essential in treating the patients with extrahepatic lesions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tumor markers for early diagnosis for brain metastasis of hepatocellular carcinoma: A case series and literature review for effective loco-regional treatment

Kamimura

Kobayashi

Takahashi

et al. 2017

Cancer Biology & Therapy

View full text Add to dashboard Cite

Intrahepatic lesions of hepatocellular carcinoma (HCC) have been controlled by significant advances in treatment using loco-regional therapies, including, surgery, ablative therapy, catheter-based chemotherapy, and embolization. Consequently, the number of patients with extrahepatic metastatic lesions has increased. Their prognosis remains poor with approximately <1 y of survival from the time of diagnosis. A molecularly targeted drug, sorafenib, have been used to treat extrahepatic lesions and shown the prolonged survival time. However, the therapeutic benefit for the brain metastasis remains unclear, since it causes intratumor bleeding leading to the severe brain damage. No guidelines for the brain metastasis of HCC have been developed to date due to the shortage of the experiences and evidences. Therefore, the development of standard therapy for brain metastasis following the early diagnosis is essential by accumulating the information of clinical courses and evidences. For this purpose, we reviewed cases of HCC brain metastasis reported to date and analyzed additional 8 cases from our hospital, reviewing 592 advanced HCC cases to estimate the possible metastatic lesions in the brain. With careful review of cases and literature, we suggest that the cases with lung metastasis with increase tendency of tumor markers within recent 3-6 months have higher risks of brain metastasis. Therefore, they should be carefully followed by imaging modalities. In addition, the loco-regional treatment, including surgical resection and radiation therapy should be performed for better prognosis by preventing re-bleeding from the tumors.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tumor markers for early diagnosis for brain metastasis of hepatocellular carcinoma: A case series and literature review for effective loco-regional treatment

Kamimura

Kobayashi

Takahashi

et al. 2017

Cancer Biology & Therapy

View full text Add to dashboard Cite

show abstract

“…In these regions, it constitutes one of the most frequent malignancies due to the high prevalence of hepatitis B and C. Men are 4.8 times more likely to be affected than women [57,66,69,70]. Information regarding BM from HCC is based on case reports [65,67,68,[71][72][73][74][75][76][77] and Case report with no patient series c One patient's therapy was not specified small case studies [57,66,[69][70][71]78]. The Japanese tumor register estimates that 1.2% of all BM originate from HCC [57,74].…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

“…Post mortem incidence is higher and ranges from 1.7% to 5% [66,[73][74][75]. Systemic metastatic disease favors development of BM [66,[70][71][72]76]. Additional lung metastases are present in 78% of patients with BM [72].…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

See 1 more Smart Citation

Modern management of rare brain metastases in adults

et al. 2011

View full text Add to dashboard Cite

Brain metastases (BM) represent the main cause of intracranial neoplasms in adults, while being relatively less common in children. Today, better treatment options of the primary malignancy lead to higher remission rates as well as prolonged stable clinical conditions. This may in part explain the increased incidence of BM. Morbidity and mortality rates in patients with malignancies deteriorate significantly in cases of metastatic involvement of the central nervous system. Nowadays, especially modern management using surgical, medical, and radiotherapeutic options for treatment of BM tends to improve survival rates and enhance quality of life. Nonetheless, almost all treatment options are considered as palliative. In this review, we outline current knowledge of the incidence, diagnostic facilities, and therapeutic management of rare BM, with consideration of the basic aspects of the primary malignancy.

show abstract

Stereotactic radiosurgery for brain metastases from hepatocellular carcinoma

et al. 2013

View full text Add to dashboard Cite

The purpose of this study is to investigate the possible role of stereotactic radiosurgery (SRS) in the management of patients with brain metastases from hepatocellular carcinoma (HCC). Thirty-two consecutive patients with 80 brain metastases from HCC were treated with SRS. Twenty-eight (87.5 %) patients were male, and the mean age of the patients was 54 ± 12 years (range 22-73). Twenty-seven (84.4 %) patients were classified as RTOG RPA Class 2. The mean tumor volume was 6.14 ± 11.3 cm(3) (range 0.01-67.3). The mean marginal dose prescribed was 20.1 ± 3.6 Gy (range 10.0-25.0). The median overall survival time after SRS was 11.3 ± 5.8 weeks (95 % CI 0-22.7). A greater total volume of brain metastases (>14 cm(3)) was the only independent prognostic factor (HR = 2.419; 95 % CI 1.040-5.624; p = 0.040). The actuarial control rate of brain metastases was 51.3 % at 4 months after SRS. The prescribed marginal dose (>18 Gy) was significantly related with the actuarial tumor control (HR = 0.254; 95 % CI 0.089-0.725; p = 0.010). The prognosis of patients with brain metastases from HCC is dismal even with the modern technology of radiosurgery. The marginal dose prescribed should be reevaluated to improve upon the current poor local control rates.

show abstract

Brain Metastasis from Hepatocellular Carcinoma Treated with a Cyber-Knife

Abstract: Abstract

Cited by 11 publications

References 8 publications

Tumor markers for early diagnosis for brain metastasis of hepatocellular carcinoma: A case series and literature review for effective loco-regional treatment

Tumor markers for early diagnosis for brain metastasis of hepatocellular carcinoma: A case series and literature review for effective loco-regional treatment

Modern management of rare brain metastases in adults

Stereotactic radiosurgery for brain metastases from hepatocellular carcinoma

Contact Info

Product

Resources

About