Open AccessDynamic tumor-tracking stereotactic body radiation therapy for a solitary tumor in a transplanted organ: two case reports
Author(s) -
Satoki Okabayashi,
Yukinori Matsuo,
Noriko Kishi,
Hideki Hanazawa,
Takashi Mizowaki
Publication year - 2020
Publication title -
international cancer conference journal
Language(s) - English
Resource type - Journals
ISSN - 2192-3183
DOI - 10.1007/s13691-020-00429-z
Subject(s) - medicine , malignancy , hepatocellular carcinoma , cirrhosis , radiation therapy , pneumonitis , metastasis , radiosurgery , liver function , transplantation , liver transplantation , radiology , cancer , surgery , lung
Solid-organ transplant recipients require long-term immunosuppressants to prevent graft rejection. However, immunosuppressant use increases the risk of malignancy. Radiotherapy can be a treatment option for patients who are medically inoperable or refuse surgery; however, whether the irradiation of transplanted organs is safe remains unclear. We present two patients with malignancies that developed in transplanted organs and were treated with dynamic tumor-tracking (DTT) stereotactic body radiation therapy (SBRT). The first patient underwent transplantation owing to liver cirrhosis caused by hepatitis C virus and subsequently developed hepatocellular carcinoma in the donated liver. There was no evidence of recurrence 12 months post-treatment, and liver function enzyme levels did not deviate from their pre-SBRT baselines. The second patient had a solitary tongue cancer metastasis in a transplanted lung; she also had a history of interstitial pneumonia caused by scleroderma. Six weeks after DTT-SBRT, she developed grade 3 radiation pneumonitis but recovered with oral steroids; she experienced no tumor recurrence after 14 months, although her respiratory function was worse than it was pre-SBRT owing to post-transplant rejection. DTT-SBRT is thus feasible for treating tumors that arise in transplanted lungs and livers.