Phase I Radiation Dose-Escalation Study to Investigate the Dose-Limiting Toxicity of Concurrent Intra-Arterial Chemotherapy for Unresectable Hepatocellular Carcinoma
| Autor: | Seung-Moon Joo, Ik Jae Lee, Kwan Sik Lee, Jin Hong Lim, Ja Kyung Kim, Jun Won Kim, Yeona Cho, Hyun Woong Lee, Kwang Hun Lee, Jung Il Lee |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
medicine.medical_specialty Hepatocellular carcinoma medicine.medical_treatment Intra arterial chemotherapy Urology lcsh:RC254-282 Article 030218 nuclear medicine & medical imaging chemoradiotherapy 03 medical and health sciences 0302 clinical medicine medicine Adverse effect radiotherapy Chemotherapy business.industry Radiation dose toxicity medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Radiation therapy Oncology 030220 oncology & carcinogenesis Toxicity business Chemoradiotherapy |
| Zdroj: | Cancers, Vol 12, Iss 1612, p 1612 (2020) Cancers Volume 12 Issue 6 |
| ISSN: | 2072-6694 |
| Popis: | Concurrent intra-arterial chemotherapy and radiotherapy (iA-CCRT) can increase the response rate in hepatocellular carcinoma (HCC), but may cause a higher toxicity. We conducted this Phase I study to investigate the dose-limiting toxicity of iA-CCRT for HCC. In total, 52.5 Gy in 25 fractions was prescribed as planning target volume (PTV) 1 at dose level 1. The dose escalation was 0.2 Gy per fraction and up to 2.5 Gy, with 62.5 Gy at level 3. Concurrent intra-arterial 5-fluorouracil was administered during the first and fifth weeks of radiotherapy (RT). Toxicities were graded using the Common Toxicity Criteria for Adverse Events, version 4.0. Results: Seventeen patients with HCC were analyzed: four at dose level 1, 6 at level 2, and 7 at level 3. The mean irradiated dose administered to the uninvolved liver at each dose level was 21.3, 21.6, and 18.2 Gy, respectively. There was no grade &ge 3 gastrointestinal toxicity two patients experienced grade 3 hyperbilirubinemia. All patients had Child-Pugh class A disease, but 3 patients developed class B disease after iA-CCRT. During a median follow-up of 13 months, the median progression-free survival (PFS) and overall survival (OS) were 10 and 22 months, respectively. Patients treated at dose level 3 showed improved PFS and OS. Conclusions: Radiation dose escalation of iA-CCRT did not cause any significant toxicities in patients with advanced HCC. Further large-scale studies with long-term follow-up are needed to determine the efficacy and feasibility of higher doses of iA-CCRT. |
| Databáze: | OpenAIRE |
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