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Treatment outcomes of stereotactic body radiation therapy using a real‐time tumor‐tracking radiotherapy system for hepatocellular carcinomas
Author(s) -
Uchinami Yusuke,
Katoh Norio,
Abo Daisuke,
Taguchi Hiroshi,
Yasuda Koichi,
Nishioka Kentaro,
Soyama Takeshi,
Morita Ryo,
Miyamoto Naoki,
Suzuki Ryusuke,
Sho Takuya,
Nakai Masato,
Ogawa Koji,
Kakisaka Tatsuhiko,
Orimo Tatsuya,
Kamiyama Toshiya,
Shimizu Shinichi,
Aoyama Hidefumi
Publication year - 2021
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13649
Subject(s) - medicine , hepatocellular carcinoma , confidence interval , radiation therapy , nuclear medicine , stereotactic radiotherapy , multivariate analysis , surgery , radiosurgery
Aim To report the outcomes of stereotactic body radiotherapy using a real‐time tumor‐tracking radiotherapy system for hepatocellular carcinoma patients. Methods From January 2005 to July 2018, 63 patients with 74 lesions with a maximum diameter ≤52 mm were treated by stereotactic body radiotherapy using a real‐time tumor‐tracking radiotherapy system. No patient with a Child–Pugh Score ≥9 was included, and 85.6% had a score of 5 or 6. Using the biological effective dose (BED) with an α/β ratio of 10 (BED 10 ), the median dose in BED 10 at the reference point was 76.8 Gy (range 60–122.5 Gy). Overall survival (OS) and local control rates were assessed using the Kaplan–Meier method. Results With a median follow‐up period of 24.6 months (range 0.9–118.4 months), the 1‐year and 2‐year OS rates were 86.8% (95% confidence interval [95% CI] 75.8–93.3) and 71.1% (57.8–81.6), respectively. The 2‐year OS was 89.6% in patients with the baseline modified albumin‐bilirubin (mALBI) grade =1, and 61.7% in patients with grade ≥2a. In the multivariate analysis, the mALBI grade (=1 vs. ≥2a) was a significant factor for OS ( p = 0.028, 95% CI 1.11–6.18). The 1‐year and 2‐year local control rates were 100% (100–100%) and 92.0% (77.5–97.5%). The local control rates were significantly higher in the BED 10 ≥100 Gy group than in the BED 10 <100 Gy group (2‐year 100% vs. 86.5%, p = 0.049) at the reference point. Conclusion This retrospective study of stereotactic body radiotherapy using real‐time tumor‐tracking radiotherapy for hepatocellular carcinoma showed favorable outcomes with lower incidence of toxicities, especially in patients treated with BED 10 ≥100 Gy to the reference point.