Stereotactic body radiation therapy using a respiratory-gated volumetric-modulated arc therapy technique for small hepatocellular carcinoma.

Abstract

BACKGROUND:

Volumetric-modulated arc therapy (VMAT) is a highly sophisticated linear accelerator-based treatment method, and allows dose rate-changing intensity modulation with gantry rotation. We report our clinical experiences with stereotactic body radiation therapy (SBRT) using a respiratory-gated VMAT technique for patients with hepatocellular carcinoma (HCC) when established curative treatments cannot be applied.

METHODS:

A total of 119 patients (139 lesions) with HCC who were treated with SBRT were registered between March 2012 and July 2013 at our institution. A dose of 10-15 Gy per fraction was applied over 3-4 consecutive days, resulting in a total dose of 30-60 Gy.

RESULTS:

The median follow-up period was 25.8 months (range, 3.2-36.8 months). The overall 3-year survival rate was 83.8%. The local control rate at 3 years was 97.0% in all treated lesions. Multivariate analysis revealed that the Child-Pugh class before SBRT had significant effects on overall survival (Child-Pugh A: hazard ratio = 0.463; 95% CI, 0.262-0.817; p = 0.008).

CONCLUSIONS:

SBRT using a respiratory-gated VMAT technique was an excellent ablative treatment modality for patients with HCC. SBRT is a good alternative treatment for patients with small HCCs that are unsuitable for surgical resection or local ablative therapy.

• Authors: Yuri Jeong, Jinhong Jung, Byungchul Cho, Jungwon Kwak, Chiyoung Jeong, Jong Hoon Kim, Jin-Hong Park, So Yeon Kim, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Sang Min Yoon
• Journal: BMC cancer (BMC Cancer) Vol. 18 Issue 1 Pg. 416 (04 13 2018) ISSN: 1471-2407 [Electronic] England
• PMID: 29653562 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (diagnostic imaging, pathology, radiotherapy)
• Female
• Follow-Up Studies
• Humans
• Liver Neoplasms (diagnostic imaging, pathology, radiotherapy)
• Male
• Middle Aged
• Neoplasm Staging
• Radiosurgery (adverse effects, methods)
• Radiotherapy, Intensity-Modulated (adverse effects, methods)
• Retrospective Studies
• Tomography, X-Ray Computed
• Treatment Outcome
• Tumor Burden