Radiothérapie des tumeurs hépatiques

Rio, E.; Mornex, F.; Peiffert, D.; Huertas, Alice

doi:10.1016/j.canrad.2016.07.019

Cited by 9 publications

(3 citation statements)

References 39 publications

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“…Only the National Comprehensive Cancer Network (NCCN) [ 58 ] has integrated conformational or stereotactic radiotherapy into treatment algorithms, as an option in inoperable tumors. The SFRO (French radiotherapy society) has established selection criteria for liver SBRT which are a number of lesions less than or equal to three, a tumor size not exceeding 5 cm and a volume of healthy liver parenchyma of at least 700 cm 3 [ 16 , 59 , 60 ]. Added to this is a preserved general condition, a Child Pugh ≤ B7 and controlled extrahepatic disease.…”

Section: Discussionmentioning

confidence: 99%

Image-Guided Liver Stereotactic Body Radiotherapy Using VMAT and Real-Time Adaptive Tumor Gating: Evaluation of the Efficacy and Toxicity for Hepatocellular Carcinoma

Cantaloube

Castan

Creoff

et al. 2021

Cancers

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Liver SBRT is a therapeutic option for the treatment of HCC in patients not eligible for other local therapies. We retrospectively report the outcomes of a cohort of consecutive patients treated with SBRT for HCC at the Montpellier Cancer Institute. Between March 2013 and December 2018, 66 patients were treated with image-guided liver SBRT using VMAT and real-time adaptive tumor gating in our institute. The main endpoints considered in this study were local control, disease-free survival, overall survival, and toxicity. The median follow-up was 16.8 months. About 66.7% had prior liver treatment. Most patients received 50 Gy in five fractions of 10 Gy. No patient had local recurrence. Overall survival and disease-free survival were, respectively, 83.9% and 46.7% at one year. In multivariate analysis, the diameter of the lesions was a significant prognostic factor associated with disease-free survival (HR = 2.57 (1.19–5.53) p = 0.02). Regarding overall survival, the volume of PTV was associated with lower overall survival (HR = 2.84 (1.14–7.08) p = 0.025). No grade 3 toxicity was observed. One patient developed a grade 4 gastric ulcer, despite the dose constraints being respected. Image-guided liver SBRT with VMAT is an effective and safe treatment in patients with inoperable HCC, even in heavily pre-treated patients. Further prospective evaluation will help to clarify the role of SBRT in the management of HCC patients.

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Section: Discussionmentioning

confidence: 99%

Image-Guided Liver Stereotactic Body Radiotherapy Using VMAT and Real-Time Adaptive Tumor Gating: Evaluation of the Efficacy and Toxicity for Hepatocellular Carcinoma

Cantaloube

Castan

Creoff

et al. 2021

Cancers

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“…Lorsque le patient pour lequel une radiothérapie stéréotaxique hépatique est envisagée est atteint d'une cirrhose, celle-ci doit être équilibrée et elle n'est pas recommandée chez les patients avec une fonction hépatique altérée (score de Child Pugh B8 et au-delà) [15]. La bonne tolérance et le caractère non invasif de la radiothérapie stéréotaxique hépatique font qu'elle est souvent proposée à des patients présentant des comorbidités ou une hypertension portale importante qui rendent les alternatives thérapeutiques limitées [4].…”

Section: Particularités Cliniques Du Patient Pris En Chargeunclassified

“…Une planification multimodale est indispensable pour appréhender de manière fiable les volumes cibles et les organes à risque [4, 15,17]. Une scanographie de simulation avec injection de produit de contraste et acquisitions bi-ou triphasiques est nécessaire (en l'absence de contrindications) pour le traitement des tumeurs hépatiques.…”

Section: Planification Multimodale Et Guidage Par L'imageunclassified

Radiothérapie stéréotaxique hépatique : particularités cliniques et implications techniques, résultats. Quelle machine pour quelle situation ?

Riou

Valdenaire

Debuire

et al. 2019

Cancer/Radiothérapie

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Role of phosphatidylinositol 3‐kinase signaling pathway in radiation‐induced liver injury

Xiao

Zhang

Yang

et al. 2020

The Kaohsiung J of Med Scie

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Transforming growth factor‐β1 (TGF‐β1) is one of critical cytokines in radiation‐induced liver injury. Hepatic stellate cells (HSC) are activated in the early stage of radiation‐induced liver injury. However, it is currently unclear whether phosphatidylinositol 3‐kinase (PI3K/Akt) signal pathway is activated in radiation‐induced liver injury. Herein, male Sprague‐Dawley rats were irradiated with 6 MV X‐rays (30 Gy) on the right liver. Next, Hematoxylin and eosin staining, Masson staining, and electron microscopy were performed to examine pathological changes. Immunohistochemistry was performed to assess the expression of TGF‐β1, α‐SMA, and p‐Akt (S473) in liver tissues. In vitro, rat HSC cell line HSC‐T6 cells were given different doses of 6 MV X‐ray irradiation (10 and 20 Gy) and treated with LY294002. The expression of α‐SMA and p‐Akt in mRNA and protein levels were measured by reverse transcription‐polymerase chain reactioin (RT‐PCR) and Western blot. TGF‐β1 expression was detected by enzyme‐linked immuno sorbent assay (ELISA). After irradiation, the liver tissues showed obvious pathological changes, indicating the establishment of the radiation‐induced liver injury. Expression levels of TGF‐β1, α‐SMA, and p‐Akt (S473) protein in liver tissues were significantly increased after irradiation, and this increase was in a time‐dependent manner, suggesting the activation of HSC and PI3K/Akt signal pathway. in vitro experiments showed that the TGF‐β1 secreted by HSCs, and the expression of Akt and α‐SMA at mRNA and protein levels were significantly increased in irradiation groups. However, the expression of TGF‐β1, Akt, and α‐SMA were significantly decreased in PI3K/Akt signal pathway inhibitor LY294002‐treated group. Our results suggest that during radiation‐induced liver injury, HSCs are activated by TGF‐β1‐mediated PI3K/Akt signal pathway.

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Radiothérapie des tumeurs hépatiques

Cited by 9 publications

References 39 publications

Image-Guided Liver Stereotactic Body Radiotherapy Using VMAT and Real-Time Adaptive Tumor Gating: Evaluation of the Efficacy and Toxicity for Hepatocellular Carcinoma

Image-Guided Liver Stereotactic Body Radiotherapy Using VMAT and Real-Time Adaptive Tumor Gating: Evaluation of the Efficacy and Toxicity for Hepatocellular Carcinoma

Radiothérapie stéréotaxique hépatique : particularités cliniques et implications techniques, résultats. Quelle machine pour quelle situation ?

Role of phosphatidylinositol 3‐kinase signaling pathway in radiation‐induced liver injury

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