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Repeated stereotactic ablative radiotherapy using CyberKnife for patients with hepatocellular carcinoma
Cheng-Hsiang Lo1, Wen-Yen Huang, Kuen-Tze Lin
1Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Journal of Gastroenterology and Hepatology
|July 22, 2014
Summary
Repeated stereotactic ablative radiotherapy (SABR) for recurrent hepatocellular carcinoma (HCC) showed good tumor control and manageable side effects. This treatment is feasible for selected patients, offering a viable option for managing liver cancer recurrence.
Area of Science:
- Oncology
- Radiation Oncology
- Hepatobiliary Medicine
Background:
- Hepatocellular carcinoma (HCC) recurrence after initial treatment poses a significant clinical challenge.
- Stereotactic ablative radiotherapy (SABR) is an established treatment for primary and recurrent HCC.
- Data on the safety and efficacy of *repeated* SABR for HCC are limited.
Purpose of the Study:
- To evaluate the clinical outcomes of repeated liver SABR in patients with recurrent HCC.
- To assess the toxicity profile associated with repeat SABR courses in this patient population.
Main Methods:
- A cohort of 14 HCC patients with local recurrence (18 lesions) after prior liver SABR underwent repeat SABR using CyberKnife.
- Treatment details included median doses for first and second SABR courses and the interval between treatments.
- Local recurrence was categorized as in-field or out-field failures.
Main Results:
- Objective response rates were 61.1% (27.8% complete response).
- The 2-year in-field failure-free rate was 88.2%, with only one in-field failure observed.
- Progression-free survival at 1 and 2 years was 68.6% and 42.9%, respectively; overall survival rates were 76% and 59.1%.
Conclusions:
- Repeated SABR is a feasible treatment option for selected patients with recurrent HCC.
- The toxicity profile of repeated SABR was generally mild and tolerable, with a low incidence of severe radiation-induced liver disease.
