Simultaneous integrated boost-intensity modulated radiation therapy for inoperable hepatocellular carcinoma
Tae Hyun Kim1, Joong-Won Park, Yeon-Joo Kim
1Center for Liver Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro Ilsandong-gu, Goyang-si, 410-769, Gyeonggi-do, Republic of Korea.
Summary
Simultaneous integrated boost-intensity modulated radiation therapy (SIB-IMRT) is a safe and effective treatment for inoperable hepatocellular carcinoma (HCC). This study found SIB-IMRT well-tolerated with promising survival rates for HCC patients.
Area of Science:
- Radiation Oncology
- Hepatobiliary Malignancies
- Cancer Therapy
Background:
- Inoperable hepatocellular carcinoma (HCC) presents significant treatment challenges.
- Intensity-modulated radiation therapy (IMRT) offers precise dose delivery for complex tumors.
Purpose of the Study:
- To assess the clinical efficacy and safety of simultaneous integrated boost-intensity modulated radiation therapy (SIB-IMRT) in patients with inoperable HCC.
- To compare outcomes between different dose-fractionation schemes based on proximity to gastrointestinal structures.
Main Methods:
- 53 patients with inoperable HCC received SIB-IMRT with two dose-fractionation protocols.
- Low dose-fractionation (LD) for tumors near gastrointestinal (GI) structures; high dose-fractionation (HD) for tumors further from GI structures.
- Dose prescriptions varied: LD (55/44 Gy), HD (66/55 Gy) in 22 fractions to PTV1/PTV2.
Main Results:
- SIB-IMRT was well-tolerated, with no grade > 3 toxicity observed.
- The HD group demonstrated superior tumor response (100% vs. 62.2%) and trends towards better 2-year LPFS, RFS, and OS rates compared to the LD group.
- Tumor response was significantly associated with overall survival (OS) in multivariate analysis.
Conclusions:
- SIB-IMRT is a feasible and safe treatment modality for patients diagnosed with inoperable HCC.
- The high dose-fractionation scheme may offer improved outcomes in terms of tumor control and survival.
