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Repeated stereotactic ablative radiotherapy using C yber K nife for patients with hepatocellular carcinoma
Author(s) -
Lo ChengHsiang,
Huang WenYen,
Lin KuenTze,
Lin MiaoJung,
Lin TePao,
Jen YeeMin
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12659
Subject(s) - sabr volatility model , medicine , hepatocellular carcinoma , radiation therapy , ablative case , cirrhosis , gastroenterology , surgery , nuclear medicine , volatility (finance) , stochastic volatility , financial economics , economics
Background and Aim This study aimed to evaluate the outcomes and toxicities of repeated stereotactic ablative radiotherapy ( SABR ) in hepatocellular carcinoma ( HCC ). Methods Fourteen HCC patients with local recurrence (18 lesions) after liver SABR received repeated radiotherapy with SABR using C yberKnife. No patients experienced radiation‐induced liver disease after the first SABR course. The median first SABR dose was 41 G y (range, 34–60 G y); the median second SABR dose, 40 G y (range, 25–50 G y); and the median interval, 12.9 months. Local recurrence was divided into in‐field recurrence and out‐field recurrence. Results Objective responses were observed in 11 tumors (61.1%), including five tumors (27.8%) with complete responses. Intrahepatic out‐field failure was the main cause of treatment failure (7 of 14 patients). In‐field failure had developed in 1 of 18 tumors (5.6%), resulting in a 2‐year in‐field failure‐free rate of 88.2%. The median time to progression was 14.0 months, with 1‐ and 2‐year progression‐free survival rates of 68.6% and 42.9%, respectively. One‐ and two‐year overall survival rates were 76% and 59.1%, respectively. Of the 14 patients, one developed radiation‐induced liver disease and three showed progression of the C hild‐ T urcotte‐ P ugh class after the second SABR course. Other toxicities were generally mild and tolerable. Conclusion Repeated SABR in selected HCC patients is feasible with acceptable toxicity.