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Article: Combined stereotactic body radiotherapy and trans-arterial chemoembolization as initial treatment in BCLC stage B-C hepatocellular carcinoma.

TitleCombined stereotactic body radiotherapy and trans-arterial chemoembolization as initial treatment in BCLC stage B-C hepatocellular carcinoma.
Kombinierte stereotaktische Körperstamm-Strahlentherapie und transarterielle Chemoembolisation als Erstlinientherapie beim hepatozellulären Karzinom im BCLC-Stadium B–C
Authors
KeywordsBCLC stage B-C
Hepatocellular carcinoma
Initial therapy
Stereotactic body radiotherapy
Transarterial chemoembolization
Issue Date2018
PublisherSpringer Medizin. The Journal's web site is located at http://www.springer.com/medicine/radiology/journal/66
Citation
Strahlentherapie und Onkologie: Zeitschrift fuer Radiologie, Strahlenbiologie, Strahlenphysik, 2018, v. 195 n. 3, p. 254-264 How to Cite?
AbstractPurpose: We retrospectively evaluated the efficacy and safety of stereotactic body radiotherapy (SBRT) combined with trans-arterial chemoembolization (TACE) as initial therapy in Barcelona Clinic Liver Cancer (BCLC) system stage B–C hepatocellular carcinoma (HCC). Patients and methods: Seventy-two patients received a single dose of TACE followed by SBRT 4 weeks later. All patients had tumor sizes ≥5 cm, at least 700 ml of disease-free liver, Child–Pugh (CP) score ≤ B7 and tumor nodules ≤5. SBRT dose, ranging from 6 × 5–8 Gy or 5–10 × 4 Gy, was individualized according to normal tissue constraints. No subsequent scheduled treatment was delivered unless disease progression was observed. Local control (LC), overall survival (OS), progression-free survival (PFS), response rate (RR), and toxicity were evaluated. Results: The patients’ characteristics were: median age 60 years (range 28–87 years); CP score A/B (n = 68/4); BCLC stage B/C (n = 51/21); solitary/multifocal (n = 37/35); portal vein invasion (n = 18). The median tumor size and GTV were 11.2 cm (range 5.0–23.6 cm) and 751 cm 3 (range 41–4009 cm 3 ), respectively. The median equivalent dose in 2 Gy per fraction (EQD2, α/β = 10) was 37.3 Gy2 (range, 28–72 Gy2). The median follow-up time was 16.8 months (range, 3–96 months). The objective RR was 68% and the 1‑year LC rate was 93.6% (95% CI, 87.6–100%). The median OS was 19.8 months (95% CI, 11.6–30.6 months). SBRT-related grade 3 or higher adverse gastrointestinal events and treatment-related death occurred in three (2.8%) and one patient (1.4%) respectively. No patient developed classical radiation-induced liver injury. Conclusion: Our experience suggests that combined TACE and SBRT can be a safe and effective initial therapy for BCLC stage B–C HCC with appropriate patient selection. Further prospective trials are warranted. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Persistent Identifierhttp://hdl.handle.net/10722/275711
ISSN
2017 Impact Factor: 2.459
2015 SCImago Journal Rankings: 1.069
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChiang, CL-
dc.contributor.authorChan, MHK-
dc.contributor.authorYeung, CSY-
dc.contributor.authorHo, CHM-
dc.contributor.authorLee, FAS-
dc.contributor.authorLee, VWY-
dc.contributor.authorWong, FCS-
dc.contributor.authorBlanck, O-
dc.date.accessioned2019-09-10T02:48:06Z-
dc.date.available2019-09-10T02:48:06Z-
dc.date.issued2018-
dc.identifier.citationStrahlentherapie und Onkologie: Zeitschrift fuer Radiologie, Strahlenbiologie, Strahlenphysik, 2018, v. 195 n. 3, p. 254-264-
dc.identifier.issn0179-7158-
dc.identifier.urihttp://hdl.handle.net/10722/275711-
dc.description.abstractPurpose: We retrospectively evaluated the efficacy and safety of stereotactic body radiotherapy (SBRT) combined with trans-arterial chemoembolization (TACE) as initial therapy in Barcelona Clinic Liver Cancer (BCLC) system stage B–C hepatocellular carcinoma (HCC). Patients and methods: Seventy-two patients received a single dose of TACE followed by SBRT 4 weeks later. All patients had tumor sizes ≥5 cm, at least 700 ml of disease-free liver, Child–Pugh (CP) score ≤ B7 and tumor nodules ≤5. SBRT dose, ranging from 6 × 5–8 Gy or 5–10 × 4 Gy, was individualized according to normal tissue constraints. No subsequent scheduled treatment was delivered unless disease progression was observed. Local control (LC), overall survival (OS), progression-free survival (PFS), response rate (RR), and toxicity were evaluated. Results: The patients’ characteristics were: median age 60 years (range 28–87 years); CP score A/B (n = 68/4); BCLC stage B/C (n = 51/21); solitary/multifocal (n = 37/35); portal vein invasion (n = 18). The median tumor size and GTV were 11.2 cm (range 5.0–23.6 cm) and 751 cm 3 (range 41–4009 cm 3 ), respectively. The median equivalent dose in 2 Gy per fraction (EQD2, α/β = 10) was 37.3 Gy2 (range, 28–72 Gy2). The median follow-up time was 16.8 months (range, 3–96 months). The objective RR was 68% and the 1‑year LC rate was 93.6% (95% CI, 87.6–100%). The median OS was 19.8 months (95% CI, 11.6–30.6 months). SBRT-related grade 3 or higher adverse gastrointestinal events and treatment-related death occurred in three (2.8%) and one patient (1.4%) respectively. No patient developed classical radiation-induced liver injury. Conclusion: Our experience suggests that combined TACE and SBRT can be a safe and effective initial therapy for BCLC stage B–C HCC with appropriate patient selection. Further prospective trials are warranted. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.-
dc.languageeng-
dc.publisherSpringer Medizin. The Journal's web site is located at http://www.springer.com/medicine/radiology/journal/66-
dc.relation.ispartofStrahlentherapie und Onkologie: Zeitschrift fuer Radiologie, Strahlenbiologie, Strahlenphysik-
dc.rightsThis is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: http://dx.doi.org/[insert DOI]-
dc.subjectBCLC stage B-C-
dc.subjectHepatocellular carcinoma-
dc.subjectInitial therapy-
dc.subjectStereotactic body radiotherapy-
dc.subjectTransarterial chemoembolization-
dc.titleCombined stereotactic body radiotherapy and trans-arterial chemoembolization as initial treatment in BCLC stage B-C hepatocellular carcinoma.-
dc.titleKombinierte stereotaktische Körperstamm-Strahlentherapie und transarterielle Chemoembolisation als Erstlinientherapie beim hepatozellulären Karzinom im BCLC-Stadium B–C-
dc.typeArticle-
dc.identifier.emailChiang, CL: chiangcl@hku.hk-
dc.identifier.authorityChiang, CL=rp02241-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00066-018-1391-2-
dc.identifier.pmid30413833-
dc.identifier.scopuseid_2-s2.0-85056339139-
dc.identifier.hkuros303259-
dc.identifier.volume195-
dc.identifier.issue3-
dc.identifier.spage254-
dc.identifier.epage264-
dc.identifier.isiWOS:000459316200008-
dc.publisher.placeGermany-

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