Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.

<h4>Background</h4>Even with early stage hepatocellular carcinoma (HCC), patients are often ineligible for surgical resection, transplantation, or local ablation due to advanced cirrhosis, donor shortage, or difficult location. Stereotactic body radiation therapy (SBRT) has been establis...

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Autores principales:	Sang Min Yoon, Young-Suk Lim, Mee Jin Park, So Yeon Kim, Byungchul Cho, Ju Hyun Shim, Kang Mo Kim, Han Chu Lee, Young-Hwa Chung, Yung Sang Lee, Sung Gyu Lee, Yu Sun Lee, Jin-Hong Park, Jong Hoon Kim
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/004988b22d674707ae936e2cca4670a1
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spelling	oai:doaj.org-article:004988b22d674707ae936e2cca4670a12021-11-18T08:47:38ZStereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.1932-620310.1371/journal.pone.0079854https://doaj.org/article/004988b22d674707ae936e2cca4670a12013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24255719/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Even with early stage hepatocellular carcinoma (HCC), patients are often ineligible for surgical resection, transplantation, or local ablation due to advanced cirrhosis, donor shortage, or difficult location. Stereotactic body radiation therapy (SBRT) has been established as a standard treatment option for patients with stage I lung cancer, who are not eligible for surgery, and may be a promising alternative treatment for patients with small HCC who are not eligible for curative treatment.<h4>Materials and methods</h4>A registry database of 93 patients who were treated with SBRT for HCC between 2007 and 2009 was analyzed. A dose of 10-20 Gy per fraction was given over 3-4 consecutive days, resulting in a total dose of 30-60 Gy. The tumor response was determined using dynamic computed tomography or magnetic resonance imaging, which was performed 3 months after completion of SBRT.<h4>Results</h4>The median follow-up period was 25.6 months. Median size of tumors was 2 cm (range: 1-6 cm). Overall patients' survival rates at 1 and 3 years were 86.0% and 53.8%, respectively. Complete and partial tumor response were achieved in 15.5% and 45.7% of patients, respectively. Local recurrence-free survival rate was 92.1% at 3 years. Most local failures were found in patients with HCCs > 3 cm, and local control rate at 3 years was 76.3% in patients with HCC > 3 cm, 93.3% in patients with tumors between 2.1-3 cm, and 100% in patients with tumors ≤ 2 cm, respectively. Out-of-field intrahepatic recurrence-free survival rates at 1 and 3 years were 51.9% and 32.4%, respectively. Grade ≥ 3 hepatic toxicity was observed in 6 (6.5%).<h4>Conclusions</h4>SBRT was effective in local control of small HCC. SBRT may be a promising alternative treatment for patients with small HCC which is unsuitable for other curative therapy.Sang Min YoonYoung-Suk LimMee Jin ParkSo Yeon KimByungchul ChoJu Hyun ShimKang Mo KimHan Chu LeeYoung-Hwa ChungYung Sang LeeSung Gyu LeeYu Sun LeeJin-Hong ParkJong Hoon KimPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e79854 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sang Min Yoon Young-Suk Lim Mee Jin Park So Yeon Kim Byungchul Cho Ju Hyun Shim Kang Mo Kim Han Chu Lee Young-Hwa Chung Yung Sang Lee Sung Gyu Lee Yu Sun Lee Jin-Hong Park Jong Hoon Kim Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.
description	<h4>Background</h4>Even with early stage hepatocellular carcinoma (HCC), patients are often ineligible for surgical resection, transplantation, or local ablation due to advanced cirrhosis, donor shortage, or difficult location. Stereotactic body radiation therapy (SBRT) has been established as a standard treatment option for patients with stage I lung cancer, who are not eligible for surgery, and may be a promising alternative treatment for patients with small HCC who are not eligible for curative treatment.<h4>Materials and methods</h4>A registry database of 93 patients who were treated with SBRT for HCC between 2007 and 2009 was analyzed. A dose of 10-20 Gy per fraction was given over 3-4 consecutive days, resulting in a total dose of 30-60 Gy. The tumor response was determined using dynamic computed tomography or magnetic resonance imaging, which was performed 3 months after completion of SBRT.<h4>Results</h4>The median follow-up period was 25.6 months. Median size of tumors was 2 cm (range: 1-6 cm). Overall patients' survival rates at 1 and 3 years were 86.0% and 53.8%, respectively. Complete and partial tumor response were achieved in 15.5% and 45.7% of patients, respectively. Local recurrence-free survival rate was 92.1% at 3 years. Most local failures were found in patients with HCCs > 3 cm, and local control rate at 3 years was 76.3% in patients with HCC > 3 cm, 93.3% in patients with tumors between 2.1-3 cm, and 100% in patients with tumors ≤ 2 cm, respectively. Out-of-field intrahepatic recurrence-free survival rates at 1 and 3 years were 51.9% and 32.4%, respectively. Grade ≥ 3 hepatic toxicity was observed in 6 (6.5%).<h4>Conclusions</h4>SBRT was effective in local control of small HCC. SBRT may be a promising alternative treatment for patients with small HCC which is unsuitable for other curative therapy.
format	article
author	Sang Min Yoon Young-Suk Lim Mee Jin Park So Yeon Kim Byungchul Cho Ju Hyun Shim Kang Mo Kim Han Chu Lee Young-Hwa Chung Yung Sang Lee Sung Gyu Lee Yu Sun Lee Jin-Hong Park Jong Hoon Kim
author_facet	Sang Min Yoon Young-Suk Lim Mee Jin Park So Yeon Kim Byungchul Cho Ju Hyun Shim Kang Mo Kim Han Chu Lee Young-Hwa Chung Yung Sang Lee Sung Gyu Lee Yu Sun Lee Jin-Hong Park Jong Hoon Kim
author_sort	Sang Min Yoon
title	Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.
title_short	Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.
title_full	Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.
title_fullStr	Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.
title_full_unstemmed	Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.
title_sort	stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/004988b22d674707ae936e2cca4670a1
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Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.

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