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Feasibility and efficacy of helical tomotherapy in cirrhotic patients with unresectable hepatocellular carcinoma
BACKGROUND: This study is to evaluate the toxicity and outcomes of helical tomotherapy (HT) in patients treated for unresectable hepatocellular carcinoma (HCC). METHODS: From March 2008 to September 2010, 38 patients with unresectable HCC were treated with HT. The median patient age was 67 years (ra...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476234/ https://www.ncbi.nlm.nih.gov/pubmed/26072055 http://dx.doi.org/10.1186/s12957-015-0611-9 |
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author | Huang, Chun-Ming Huang, Ming-Yii Tang, Jen-Yang Chen, Shinn-Cherng Wang, Liang-Yen Lin, Zu-Yau Huang, Chih-Jen |
author_facet | Huang, Chun-Ming Huang, Ming-Yii Tang, Jen-Yang Chen, Shinn-Cherng Wang, Liang-Yen Lin, Zu-Yau Huang, Chih-Jen |
author_sort | Huang, Chun-Ming |
collection | PubMed |
description | BACKGROUND: This study is to evaluate the toxicity and outcomes of helical tomotherapy (HT) in patients treated for unresectable hepatocellular carcinoma (HCC). METHODS: From March 2008 to September 2010, 38 patients with unresectable HCC were treated with HT. The median patient age was 67 years (range, 45–85). The median follow-up period was 17.2 months (range, 7–46). All patients had liver cirrhosis. Median radiation dose was 54 Gy (range, 46–71.8) delivered in 1.8 to 2.4-Gy fractions. The planning target volumes were 241.2 ± 153.1 cm(3) (range, 45.8–722.4). Treatment responses were assessed in 3–6 months after HT. RESULTS: There was a complete response in 2 patients (5.2 %), partial response in 18 patients (47.4 %), stable disease in 13 patients (34.2 %), and progressive disease in 5 patients (13.2 %). The median overall survival was 12.6 months, and 1- and 2-year overall survival rates were 56.2 and 31.7 %, respectively. Eastern Cooperative Oncology Group (ECOG score, p = 0.008), Child-Pugh classification (p = 0.012), albumin (p = 0.046), and hemoglobin (p = 0.028) were significant parameters that predicted primary tumor response to radiotherapy in multivariate analysis. ECOG score (p = 0.012), Child-Pugh class (p = 0.026), and response to radiotherapy (p = 0.016) were independent prognostic factors for overall survival in multivariate analysis. Responders had better overall survival than non-responders (23.6 vs. 5.8 months, p < 0.001). The 1- and 2-year overall survival rates for responders were 68.3 and 57 %, respectively, while for non-responders, they were 0 %. The 1- and 2-year local control rates were 88.2 and 82.3 %, respectively. Five patients (13.2 %) had grade 3 or greater liver toxicity, and one patient (2.6 %) had a grade 3 gastric ulcer. No treatment-related liver failure or death was documented in this study. CONCLUSIONS: Radiotherapy using HT seems to be a safe and effective treatment option for unresectable HCC patients. This study indicates that HT is a feasible treatment even in patients without good performance status and hepatic function reservation. |
format | Online Article Text |
id | pubmed-4476234 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-44762342015-06-23 Feasibility and efficacy of helical tomotherapy in cirrhotic patients with unresectable hepatocellular carcinoma Huang, Chun-Ming Huang, Ming-Yii Tang, Jen-Yang Chen, Shinn-Cherng Wang, Liang-Yen Lin, Zu-Yau Huang, Chih-Jen World J Surg Oncol Research BACKGROUND: This study is to evaluate the toxicity and outcomes of helical tomotherapy (HT) in patients treated for unresectable hepatocellular carcinoma (HCC). METHODS: From March 2008 to September 2010, 38 patients with unresectable HCC were treated with HT. The median patient age was 67 years (range, 45–85). The median follow-up period was 17.2 months (range, 7–46). All patients had liver cirrhosis. Median radiation dose was 54 Gy (range, 46–71.8) delivered in 1.8 to 2.4-Gy fractions. The planning target volumes were 241.2 ± 153.1 cm(3) (range, 45.8–722.4). Treatment responses were assessed in 3–6 months after HT. RESULTS: There was a complete response in 2 patients (5.2 %), partial response in 18 patients (47.4 %), stable disease in 13 patients (34.2 %), and progressive disease in 5 patients (13.2 %). The median overall survival was 12.6 months, and 1- and 2-year overall survival rates were 56.2 and 31.7 %, respectively. Eastern Cooperative Oncology Group (ECOG score, p = 0.008), Child-Pugh classification (p = 0.012), albumin (p = 0.046), and hemoglobin (p = 0.028) were significant parameters that predicted primary tumor response to radiotherapy in multivariate analysis. ECOG score (p = 0.012), Child-Pugh class (p = 0.026), and response to radiotherapy (p = 0.016) were independent prognostic factors for overall survival in multivariate analysis. Responders had better overall survival than non-responders (23.6 vs. 5.8 months, p < 0.001). The 1- and 2-year overall survival rates for responders were 68.3 and 57 %, respectively, while for non-responders, they were 0 %. The 1- and 2-year local control rates were 88.2 and 82.3 %, respectively. Five patients (13.2 %) had grade 3 or greater liver toxicity, and one patient (2.6 %) had a grade 3 gastric ulcer. No treatment-related liver failure or death was documented in this study. CONCLUSIONS: Radiotherapy using HT seems to be a safe and effective treatment option for unresectable HCC patients. This study indicates that HT is a feasible treatment even in patients without good performance status and hepatic function reservation. BioMed Central 2015-06-15 /pmc/articles/PMC4476234/ /pubmed/26072055 http://dx.doi.org/10.1186/s12957-015-0611-9 Text en © Huang et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Huang, Chun-Ming Huang, Ming-Yii Tang, Jen-Yang Chen, Shinn-Cherng Wang, Liang-Yen Lin, Zu-Yau Huang, Chih-Jen Feasibility and efficacy of helical tomotherapy in cirrhotic patients with unresectable hepatocellular carcinoma |
title | Feasibility and efficacy of helical tomotherapy in cirrhotic patients with unresectable hepatocellular carcinoma |
title_full | Feasibility and efficacy of helical tomotherapy in cirrhotic patients with unresectable hepatocellular carcinoma |
title_fullStr | Feasibility and efficacy of helical tomotherapy in cirrhotic patients with unresectable hepatocellular carcinoma |
title_full_unstemmed | Feasibility and efficacy of helical tomotherapy in cirrhotic patients with unresectable hepatocellular carcinoma |
title_short | Feasibility and efficacy of helical tomotherapy in cirrhotic patients with unresectable hepatocellular carcinoma |
title_sort | feasibility and efficacy of helical tomotherapy in cirrhotic patients with unresectable hepatocellular carcinoma |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476234/ https://www.ncbi.nlm.nih.gov/pubmed/26072055 http://dx.doi.org/10.1186/s12957-015-0611-9 |
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