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Optimal stereotactic body radiotherapy dosage for hepatocellular carcinoma: a multicenter study
BACKGROUND: The optimal dose and fractionation scheme of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) remains unclear due to different tolerated liver volumes and degrees of cirrhosis. In this study, we aimed to verify the dose-survival relationship to optimize dose...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058965/ https://www.ncbi.nlm.nih.gov/pubmed/33882972 http://dx.doi.org/10.1186/s13014-021-01778-6 |
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author | Su, Ting-Shi Liu, Qiu-Hua Zhu, Xiao-Fei Liang, Ping Liang, Shi-Xiong Lai, Lin Zhou, Ying Huang, Yong Cheng, Tao Li, Le-Qun |
author_facet | Su, Ting-Shi Liu, Qiu-Hua Zhu, Xiao-Fei Liang, Ping Liang, Shi-Xiong Lai, Lin Zhou, Ying Huang, Yong Cheng, Tao Li, Le-Qun |
author_sort | Su, Ting-Shi |
collection | PubMed |
description | BACKGROUND: The optimal dose and fractionation scheme of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) remains unclear due to different tolerated liver volumes and degrees of cirrhosis. In this study, we aimed to verify the dose-survival relationship to optimize dose selection for treatment of HCC. METHODS: This multicenter retrospective study included 602 patients with HCC, treated with SBRT between January 2011 and March 2017. The SBRT dosage was classified into high dose, moderate dose, and low dose levels: SaRT (BED(10) ≥ 100 Gy), SbRT (EQD(2) > 74 Gy to BED(10) < 100 Gy), and ScRT (EQD(2) < 74 Gy). Overall survival (OS), progression-free survival (PFS), local control (LC), and intrahepatic control (IC) were evaluated in univariable and multivariable analyses. RESULTS: The median tumor size was 5.6 cm (interquartile range [IQR] 1.1–21.0 cm). The median follow-up time was 50.0 months (IQR 6–100 months). High radiotherapy dose correlated with better outcomes. After classifying into the SaRT, SbRT, and ScRT groups, three notably different curves were obtained for long-term post-SBRT survival and intrahepatic control. On multivariate analysis, higher radiation dose was associated with improved OS, PFS, and intrahepatic control. CONCLUSIONS: If tolerated by normal tissue, we recommend SaRT (BED(10) ≥ 100 Gy) as a first-line ablative dose or SbRT (EQD(2) ≥ 74 Gy) as a second-line radical dose. Otherwise, ScRT (EQD(2) < 74 Gy) is recommended as palliative irradiation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-021-01778-6. |
format | Online Article Text |
id | pubmed-8058965 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80589652021-04-21 Optimal stereotactic body radiotherapy dosage for hepatocellular carcinoma: a multicenter study Su, Ting-Shi Liu, Qiu-Hua Zhu, Xiao-Fei Liang, Ping Liang, Shi-Xiong Lai, Lin Zhou, Ying Huang, Yong Cheng, Tao Li, Le-Qun Radiat Oncol Research BACKGROUND: The optimal dose and fractionation scheme of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) remains unclear due to different tolerated liver volumes and degrees of cirrhosis. In this study, we aimed to verify the dose-survival relationship to optimize dose selection for treatment of HCC. METHODS: This multicenter retrospective study included 602 patients with HCC, treated with SBRT between January 2011 and March 2017. The SBRT dosage was classified into high dose, moderate dose, and low dose levels: SaRT (BED(10) ≥ 100 Gy), SbRT (EQD(2) > 74 Gy to BED(10) < 100 Gy), and ScRT (EQD(2) < 74 Gy). Overall survival (OS), progression-free survival (PFS), local control (LC), and intrahepatic control (IC) were evaluated in univariable and multivariable analyses. RESULTS: The median tumor size was 5.6 cm (interquartile range [IQR] 1.1–21.0 cm). The median follow-up time was 50.0 months (IQR 6–100 months). High radiotherapy dose correlated with better outcomes. After classifying into the SaRT, SbRT, and ScRT groups, three notably different curves were obtained for long-term post-SBRT survival and intrahepatic control. On multivariate analysis, higher radiation dose was associated with improved OS, PFS, and intrahepatic control. CONCLUSIONS: If tolerated by normal tissue, we recommend SaRT (BED(10) ≥ 100 Gy) as a first-line ablative dose or SbRT (EQD(2) ≥ 74 Gy) as a second-line radical dose. Otherwise, ScRT (EQD(2) < 74 Gy) is recommended as palliative irradiation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-021-01778-6. BioMed Central 2021-04-21 /pmc/articles/PMC8058965/ /pubmed/33882972 http://dx.doi.org/10.1186/s13014-021-01778-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Su, Ting-Shi Liu, Qiu-Hua Zhu, Xiao-Fei Liang, Ping Liang, Shi-Xiong Lai, Lin Zhou, Ying Huang, Yong Cheng, Tao Li, Le-Qun Optimal stereotactic body radiotherapy dosage for hepatocellular carcinoma: a multicenter study |
title | Optimal stereotactic body radiotherapy dosage for hepatocellular carcinoma: a multicenter study |
title_full | Optimal stereotactic body radiotherapy dosage for hepatocellular carcinoma: a multicenter study |
title_fullStr | Optimal stereotactic body radiotherapy dosage for hepatocellular carcinoma: a multicenter study |
title_full_unstemmed | Optimal stereotactic body radiotherapy dosage for hepatocellular carcinoma: a multicenter study |
title_short | Optimal stereotactic body radiotherapy dosage for hepatocellular carcinoma: a multicenter study |
title_sort | optimal stereotactic body radiotherapy dosage for hepatocellular carcinoma: a multicenter study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058965/ https://www.ncbi.nlm.nih.gov/pubmed/33882972 http://dx.doi.org/10.1186/s13014-021-01778-6 |
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