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Radiother Oncol. 2016 Oct;121(1):79-85. doi: 10.1016/j.radonc.2016.07.020. Epub 2016 Aug 23.

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

Author information

1
Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA.
2
Department of Radiation Oncology, University of Colorado School of Medicine, Colorado Springs, CO, USA.
3
Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
4
Missouri Baptist Medical Center, St. Louis, MO, USA.
5
Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA. Electronic address: pparikh@radonc.wustl.edu.

Abstract

BACKGROUND AND PURPOSE:

To report outcomes and toxicities of a single-institution phase I/II study of stereotactic body radiotherapy (SBRT) in the treatment of unresectable hepatocellular cancer (HCC) and intrahepatic cholangiocarcinoma (IHC).

MATERIALS AND METHODS:

Patients with Child-Pugh score less than 8 were eligible. A total of 32 lesions in 26 patients were treated with SBRT. Kaplan-Meier survival analysis was performed. Toxicities were graded by CTCAEv4 criteria and response was scored by EASL guidelines.

RESULTS:

Median prescribed dose was 55Gy (range 40-55Gy) delivered in 5 fractions. Mean tumor diameter was 5.0cm and mean GTV was 107cc. Median follow-up was 8.8months with a median survival of 11.1months, and one-year overall survival was 45%. Overall response rate was 42% and one-year local control was 91%. Nine patients experienced a decline in Child-Pugh class following treatment, and two grade 5 hepatic failure toxicities occurred during study follow-up.

CONCLUSIONS:

Primary hepatic malignancies not amenable to surgical resection portend a poor prognosis, despite available treatment options. Though radiation-induced liver disease (RILD) is rare following SBRT, this study demonstrates a risk of hepatic failure despite adherence to protocol constraints.

KEYWORDS:

Cholangiocarcinoma; Hepatocellular carcinoma; SBRT

PMID:
27566894
PMCID:
PMC5543719
DOI:
10.1016/j.radonc.2016.07.020
[Indexed for MEDLINE]
Free PMC Article

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