Feasibility and efficacy of high-dose three-dimensional-conformal radiotherapy in cirrhotic patients with small-size hepatocellular carcinoma non-eligible for curative therapies—mature results of the French Phase II RTF-1 trial

“…Technological advances in the planning and delivery of radiotherapy (RT), such as intensity‐modulated radiotherapy (IMRT) or three‐dimensional conformal radiotherapy (3D CRT) combined with image‐guided radiotherapy (IGRT), have enabled dose escalation in RT delivered to patients with unresectable liver tumors, while sparing the adjacent organs and normal liver. Nowadays, radiotherapy plays an important role in the treatment of unresectable or inoperable HCC 3 , 4 . Combined with transcatheter arterial chemoembolization (TACE), which is the first choice for patients with unresectable HCC, radiotherapy can improve the survival of the unresectable HCC patients 5 , 6 , 7 .…”

Section: Introductionmentioning

confidence: 99%

Inter‐ and intrafractional setup errors and baseline shifts of fiducial markers in patients with liver tumors receiving free‐breathing postoperative radiation analyzed by cone‐beam computed tomography

Zhang

Wang

et al. 2014

J Applied Clin Med Phys

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This study was to evaluate the interfractional and intrafractional setup errors and baseline shifts of golden fiducial markers in patients receiving postoperative radiotherapy (RT) using cone‐beam computed tomography (CBCT) in order to calculate PTV margins for patients with liver cancer. Twelve patients with liver tumors underwent postoperative RT. CBCT images were acquired before and after the treatment. Off‐line vertebral body match and fiducial marker match were used, respectively. The results of vertebral body match represented the setup errors of the patients, while the results of fiducial marker match represented the absolute position errors of the target volume. Baseline shifts of the target volume were calculated as the absolute target position errors minus setup errors. A total of 12 patients with 214 acquisitions of CBCTs were analyzed. Both Σ and σ of setup errors and baseline shifts in left–right (L/R), superior–inferior (S/I), and anterior–posterior(A/P) directions were calculated, including interfractional and intrafractional uncertainties. Planning target volume (PTV) margins were calculated according to margin=2.5Σ+0.7σ. Margins of 1.8 mm, 3.8 mm, and 1.4 mm in L/R, S/I, and A/P directions are needed to compensate intrafractional errors when daily online CBCT correction is used. When CBCT correction with no action level (NAL) protocol is used, PTV margin should be 2.6 mm, 5.9 mm, and 2.6 mm in L/R, S/I, and A/P directions. Margins of 5.5 mm, 14.6 mm, and 7.2 mm were needed to compensate the baseline shifts when electronic portal imaging devices (EPID) or CBCT with bone match is used for online correction of setup error.PACS number: 87.55.‐x

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“…With developments of imaging techniques, conformal radiotherapy has allowed the delivery of a high dose of radiation to a precise tumor volume while sparing the surrounding normal liver parenchyma. However, survival after radiotherapy remains limited as a result of the high frequency of hepatic recurrences (4)(5)(6). Therefore, it is imperative to discover new therapeutics to improve survival in HCC patients.…”

Section: Introductionmentioning

confidence: 99%