Conformal radiation therapy for portal vein tumor thrombosis of hepatocellular carcinoma

Toya, Ryo; Murakami, Ryuji; Baba, Yuji; Nishimura, Ryuichi; Morishita, Shoji; Ikeda, Osamu; Kawanaka, Koichi; Beppu, Teruhiko; Sugiyama, Shinichi; Sakamoto, Takashi; Yamashita, Yasuyuki; Oya, Natsuo

doi:10.1016/j.radonc.2007.07.005

Cited by 106 publications

(103 citation statements)

References 23 publications

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“…Toya et al (12) reported the median survival in a similar study to be 9.6 months. Yoon et al (13) observed a median survival of 10.6 months in HCC with thrombosis treated by 3D-CRT plus TACE.…”

Section: Discussionmentioning

confidence: 88%

High dose radiotherapy with image-guided hypo-IMRT for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombi is more feasible and efficacious than conventional 3D-CRT

Hou

Zeng

Wang

et al. 2016

Jpn. J. Clin. Oncol.

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Objective: To compare the efficacies of conventional three-dimensional conformal radiotherapy and image-guided hypofractionated intensity-modulated radiotherapy treatments in advanced hepatocellular carcinoma patients with portal vein and/or inferior vena cava tumor thrombi. Methods: A total of 118 hepatocellular carcinoma patients with portal vein and/or inferior vena cava tumor thrombi who received external beam radiation therapy focused on tumor thrombi and intrahepatic tumors were retrospectively reviewed. During the three-dimensional conformal radiotherapy treatments, a median total dose of 54 Gy with a conventional fraction (1.8-2.0 Gy/fx) was delivered. During the image-guided hypofractionated intensity-modulated radiotherapy treatments, a median total dose of 60 Gy with fractions of 2.5−4.0 Gy/fx was delivered. Results: The median follow-up time was 11.8 months (range, 1.7-43.7 months). Higher radiation doses were delivered by image-guided hypofractionated intensity-modulated radiotherapy than by three-dimensional conformal radiotherapy (average dose 57.86 ± 7.03 versus 50.88 ± 6.60 Gy, P ≤ 0.001; average biological effective dose 72.35 ± 9.62 versus 61.45 ± 6.64 Gy, P < 0.001). A longer median survival was found with image-guided hypofractionated intensity-modulated radiotherapy than with three-dimensional conformal radiotherapy (15.47 versus 10.46 months, P = 0.005). Multivariate analysis showed that image-guided hypofractionated intensity-modulated radiotherapy is a significant prognostic factor for overall survival. Toxicity was mild for both image-guided hypofractionated intensity-modulated radiotherapy and three-dimensional conformal radiotherapy. Conclusions: High dose radiotherapy delivered by image-guided hypofractionated intensity-modulated radiotherapy appears to be an effective treatment that provides a survival benefit without increasing severe toxicity in hepatocellular carcinoma patients with portal vein and/or inferior vena cava tumor thrombi.

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Section: Discussionmentioning

confidence: 88%

High dose radiotherapy with image-guided hypo-IMRT for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombi is more feasible and efficacious than conventional 3D-CRT

Hou

Zeng

Wang

et al. 2016

Jpn. J. Clin. Oncol.

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“…Kim et al (2) have reported that the objective response rates of PVT were 20% with BED ,58 Gy 10 and 54.6% with BED !58 Gy 10 (P , 0.034). Toya et al (15) have also reported difference in response rates between patients who had received BED ,58 Gy 10 and BED !58 Gy 10 (80.0% vs. 21.7%, P ¼ 0.0007), and a substantially higher survival time in the BED !58 Gy 10 group (1-year survival 59.3% vs. 29.2%, P ¼ 0.0045). Kim et al (13) have shown a higher response rate of PVT in the BED !64 group compared with the BED ,64 group (50 vs. 0%, P ¼ 0.007), although BED was not a significant prognostic factor for overall survival.…”

Section: Jpn J Clin Oncol 2012;42(8) 727mentioning

confidence: 90%

“…Although the clinical results of RT for HCC with PVT have been reported, a consensus about optimal radiation dose has not been reached yet. Biologic effective dose (BED) has been reported in previous studies as a significant prognostic factor affecting survival or tumour control (2,13,15). The median radiation dose used in preceding studies was in the range 40 -60 Gy (13 -15).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of High-dose Three-dimensional Conformal Radiotherapy in Hepatocellular Carcinoma with Portal Vein Thrombosis

Rim

Yang

Park

et al. 2012

Japanese Journal of Clinical Oncology

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“…HCC response to radiation therapy (RT) exhibits a doseresponse relationship (5), but a fine balance is required between delivering a sufficient RT dose to control the HCC and avoiding radiation-induced liver toxicity. Radiationinduced liver injury (RILD), which occurs in 10-20% of HCC patients undergoing SBRT, remains a problematic adverse effect, because of pre-existing liver dysfunctions occurring secondary to comorbid conditions such as hepatitis B/C infection and cirrhosis (3,4).…”

mentioning

confidence: 99%

Dose–function Histogram Evaluation Using 99mTc-GSA SPECT/CT Images for Stereotactic Body Radiation Therapy Planning for Hepatocellular Carcinoma Patients: A Dosimetric Parameter Comparison

Toya

Saitô

Shiraishi

et al. 2018

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Abstract. Background/Aim: We evaluated the influence of previous treatments on the parametric discrepancies between dose-volume histograms (DVHs) and dose-function histograms (DFHs) generated based on 99m Tc-GSA SPECT images of hepatocellular carcinoma (HCC) patients treated with stereotactic body radiation therapy (SBRTPrimary liver cancer is the third most common cause of cancer death worldwide. Hepatocellular carcinoma (HCC) accounts for 85%-90% of primary liver cancers (1). Stereotactic body radiation therapy (SBRT) for HCC has been introduced as an alternative to standard treatments such as surgical resection and radiofrequency ablation (RFA) (1). SBRT delivers a highly conformal, potent dose of radiation to the tumor in some fractions, while minimizing radiation damage to organs at risk. SBRT provides excellent local control for HCC with a reported control rate of 80-90% (2-4).HCC response to radiation therapy (RT) exhibits a doseresponse relationship (5), but a fine balance is required between delivering a sufficient RT dose to control the HCC and avoiding radiation-induced liver toxicity. Radiationinduced liver injury (RILD), which occurs in 10-20% of HCC patients undergoing SBRT, remains a problematic adverse effect, because of pre-existing liver dysfunctions occurring secondary to comorbid conditions such as hepatitis B/C infection and cirrhosis (3, 4). The percentage of normal liver volume receiving a dose over the threshold dose calculated based on a dose-volume histogram (DVH) is commonly used for determining dose constraints and predicting radiation-induced liver toxicity; however, it has limited predictive ability (6, 7).A drawback of using DVH for SBRT planning in HCC is the lack of functional information because DVHs are generated based on computed tomography (CT) images, which provide only morphological information. A dosefunction histogram (DFH) generated based on single photon emission computed tomography (SPECT) images may facilitate the assessment of the functional status of organs at risk. For treatment planning in lung cancers, Marks et al. (8) performed DFH calculation using 99m Tc-labeled macroaggregated albumin and observed decreases in lung perfusion at, adjacent to, and separate from tumor in 94%, 74%, and 42% of patients, respectively. 99m Tc-labeled diethylene triamine pentaacetate-galactosyl human serum albumin 1511

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Conformal radiation therapy for portal vein tumor thrombosis of hepatocellular carcinoma

Cited by 106 publications

References 23 publications

High dose radiotherapy with image-guided hypo-IMRT for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombi is more feasible and efficacious than conventional 3D-CRT

High dose radiotherapy with image-guided hypo-IMRT for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombi is more feasible and efficacious than conventional 3D-CRT

Effectiveness of High-dose Three-dimensional Conformal Radiotherapy in Hepatocellular Carcinoma with Portal Vein Thrombosis

Dose–function Histogram Evaluation Using 99mTc-GSA SPECT/CT Images for Stereotactic Body Radiation Therapy Planning for Hepatocellular Carcinoma Patients: A Dosimetric Parameter Comparison

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