Stereotactic body radiation therapy for primary and metastatic liver tumors: A single institution phase i-ii study
Autor: | Jan N. M. IJzermans, Joost J. Nuyttens, Peter C. Levendag, P. Nowak, Rene P. Brandwijk, Wouter Wunderink, Jacco de Pooter, Shahid M. Hussain, Alejandra Méndez Romero, Ben J.M. Heijmen, Cees Verhoef |
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Přispěvatelé: | Radiotherapy, Radiology & Nuclear Medicine, Surgery |
Rok vydání: | 2006 |
Předmět: |
Adult
Male Carcinoma Hepatocellular Stereotactic body radiation therapy medicine.medical_treatment Radiosurgery medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Single institution Radiation Injuries Survival analysis Aged Aged 80 and over business.industry Liver Neoplasms Radiotherapy Dosage Hematology General Medicine Middle Aged medicine.disease Survival Analysis Radiation therapy Clinical trial Phase i ii Oncology Toxicity Feasibility Studies Female Nuclear medicine business |
Zdroj: | Acta Oncologica, 45(7), 831-837. Informa Healthcare |
ISSN: | 1651-226X 0284-186X |
Popis: | The feasibility, toxicity and tumor response of stereotactic body radiation therapy (SBRT) for treatment of primary and metastastic liver tumors was investigated. From October 2002 until June 2006, 25 patients not suitable for other local treatments were entered in the study. In total 45 lesions were treated, 34 metastases and 11 hepatocellular carcinoma (HCC). Median follow-up was 12.9 months (range 0.5-31). Median lesion size was 3.2 cm (range 0.5-7.2) and median volume 22.2 cm3 (range 1.1-322). Patients with metastases, HCC without cirrhosis, and HCC4 cm with cirrhosis were mostly treated with 3 x 12.5 Gy. Patients with HCCor =4 cm and cirrhosis received 5 x 5 Gy or 3 x 10 Gy. The prescription isodose was 65%. Acute toxicity was scored following the Common Toxicity Criteria and late toxicity with the SOMA/LENT classification. Local failures were observed in two HCC and two metastases. Local control rates at 1 and 2 years for the whole group were 94% and 82%. Acute toxicity gradeor =3 was seen in four patients; one HCC patient with Child B developed a liver failure together with an infection and died (grade 5), two metastases patients presented elevation of gamma glutamyl transferase (grade 3) and another asthenia (grade 3). Late toxicity was observed in one metastases patient who developed a portal hypertension syndrome with melena (grade 3). SBRT was feasible, with acceptable toxicity and encouraging local control. Optimal dose-fractionation schemes for HCC with cirrhosis have to be found. Extreme caution should be used for patients with Child B because of a high toxicity risk. |
Databáze: | OpenAIRE |
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