Influence of liver toxicities on prognosis after stereotactic body radiation therapy for hepatocellular carcinoma

Sanuki, Naoko; Takeda, Atsuya; Oku, Yohei; Eriguchi, Takahisa; Nishimura, Soraya; Aoki, Yosuke; Kunieda, Etsuo

doi:10.1111/hepr.12383

Cited by 44 publications

(34 citation statements)

References 28 publications

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“…The treatment plans of both patients with G5 toxicity in this study meet these new constraints and guidelines (Table 3), supporting a conclusion that additional patient factors are involved in hepatic toxicity. Sanuki et al have recently described toxicities that predict for non-classic RILD in patients with HCC receiving SBRT [22]. They have found G3 elevation in transaminases, CP score of 8 or more and/or G3 thrombocytopenia to be predictive for fatal hepatic failure.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic body radiotherapy for primary hepatic malignancies – Report of a phase I/II institutional study

Weiner

Olsen

et al. 2016

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Stereotactic body radiotherapy for primary hepatic malignancies – Report of a phase I/II institutional study

Weiner

Olsen

et al. 2016

Radiotherapy and Oncology

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“…The comprehensive term RILD includes conditions such as the different degrees of liver damage after veno-occlusive changes caused by whole or partial liver irradiation, although diagnostic criteria vary [2,3]. Recent reports propose the separation of RILD into "classical" and "nonclassical" forms (Table 1) [4,7,8]. The onset of classical RILD occurs 2-12 weeks after radiation therapy and appears after the whole-liver tolerance considered the most sensitive serum marker [9].…”

Section: The Clinical Features Of Radiation-induced Liver Diseasementioning

confidence: 99%

“…This serious condition is receiving attention now that whole organ irradiation is infrequently administered [7,8,[11][12][13]. Most symptoms of nonclassical RILD resemble those of hepatic failure, including markedly elevated levels of serum transaminases and worsening of the Child-Pugh score (e.g., jaundice, ascites).…”

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confidence: 99%

“…3. (2) Decline in liver function (worsening of Child-Pugh class ≥ 2) in the absence of classical RILD [7,11]. Sanuki et al define three clinically relevant events that affect overall survival of patients with hepatocellular carcinoma (HCC) if they occur within 12 months after administration of SBRT as follows: (1) Elevated liver transaminase levels (CTCAE Gr.…”

mentioning

confidence: 99%

“…3). (3) Worsening of the Child-Pugh score to > 8) [7]. CT and MRI of focally irradiated liver can identify focal hepatic changes.…”

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confidence: 99%

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Pathology and images of radiation-induced hepatitis: a review article

et al. 2018

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Recent advances in highly conformal radiotherapies greatly extend the indications for radiotherapy of liver tumors. However, because of poor tolerance to hepatic radiation, estimation of the intensity of irradiation of the liver is important, particularly for a cirrhotic liver. Knowledge of radiation-induced hepatitis is important for understanding how to optimize hepatic radiation therapy. Pathological changes of the irradiated liver, which include perivenular fibrosis, sinusoidal obstruction, and damage to Kupffer cells and hepatocytes, can be visualized using clinical imaging techniques. This review article discusses and illustrates the pathological and radiological changes of hepatic tumors and the surrounding parenchyma of the irradiated liver.

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The role of external beam radiotherapy in the treatment of hepatocellular cancer

Chino

Stephens

Marin

et al. 2018

Cancer

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Hepatocellular carcinoma (HCC) is increasing in incidence and mortality. Although the prognosis remains poor, long-term survival has improved from 3% in 1970 to an 18% 5-year survival rate today. This is likely because of the introduction of well tolerated, oral antiviral therapies for hepatitis C. Curative options for patients with HCC are often limited by underlying liver dysfunction/cirrhosis and medical comorbidities. Less than one-third of patients are candidates for surgery, which is the current gold standard for cure. Nonsurgical treatments include embolotherapies, percutaneous ablation, and ablative radiation. Technological advances in radiation delivery in the past several decades now allow for safe and effective ablative doses to the liver. Conformal techniques allow for both dose escalation to target volumes and normal tissue sparing. Multiple retrospective and prospective studies have demonstrated that hypofractionated image-guided radiation therapy, used as monotherapy or in combination with other liver-directed therapies, can provide excellent local control that is cost effective. Therefore, as the HCC treatment paradigm continues to evolve, ablative radiation treatment has moved from a palliative treatment to both a "bridge to transplant" and a definitive treatment.

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Influence of liver toxicities on prognosis after stereotactic body radiation therapy for hepatocellular carcinoma

Abstract: We identified three criteria that affected overall survival in HCC patients treated with SBRT. Further prospective studies are warranted to validate the safety and effect of SBRT for HCC.

Cited by 44 publications

References 28 publications

Stereotactic body radiotherapy for primary hepatic malignancies – Report of a phase I/II institutional study

Stereotactic body radiotherapy for primary hepatic malignancies – Report of a phase I/II institutional study

Pathology and images of radiation-induced hepatitis: a review article

The role of external beam radiotherapy in the treatment of hepatocellular cancer

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