Hypofractionated stereotactic radiotherapy with and without transarterial chemoembolization for small hepatocellular carcinoma not eligible for other ablation therapies

Preliminary results for efficacy and toxicity

Atsuya Takeda, Masahiko Takahashi, Etsuo Kunieda, Toshiaki Takeda, Naoko Sanuki, Yuji Koike, Kazuhiro Atsukawa, Toshio Ohashi, Hidetsugu Saito, Naoyuki Shigematsu, Atsushi Kubo

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Aim: To investigate the efficacy and toxicity of hypofractionated stereotactic radiotherapy for the treatment of patients presenting with hepatocellular carcinoma (HCC) in a single institutional setting. Methods: Sixteen patients who presented with solitary HCC, including two patients with a tumor thrombus of the portal veins, were treated with stereotactic radiotherapy with or without transarterial chemoembolization. The criteria for stereotactic radiotherapy were existence of technical difficulties for other ablation therapies, inoperable disease or refusal to undergo surgery, tumor staged as Grade A or B according to the Child-Pugh classification, and solitary tumor distant from the gastrointestinal tract and kidney with a tumor volume <100 cm 3. In 14 of 16 patients, a total dose of 35-50 Gy was delivered in 5-7 fractions over 5-9 days. Results: At the end of a mean follow-up of 612 days (median 611 days; range 244-994 days), all patients were alive. Eight of 16 patients had complete responses and seven others were judged as stable with lipiodol accumulation. In one patient, local recurrence developed after 489 days. Intrahepatic recurrences developed outside the treated volume in six patients and no extrahepatic metastases developed during follow-up. No serious treatment-related toxic manifestations developed. Conclusions: Stereotactic radiotherapy for HCC with or without transarterial chemoembolization is feasible therapy and provides good local control with a short treatment period. Stereotactic radiotherapy may be of clinical benefit in patients who are inoperable or for whom there are difficulties in other ablation therapies.

Original languageEnglish
Pages (from-to)60-69
Number of pages10
JournalHepatology Research
Volume38
Issue number1
DOIs
Publication statusPublished - 2008 Jan

Fingerprint

Hepatocellular Carcinoma
Radiotherapy
Therapeutics
Ethiodized Oil
Recurrence
Neoplasms
Poisons
Portal Vein
Tumor Burden
Gastrointestinal Tract
Thrombosis
Neoplasm Metastasis
Kidney

Keywords

  • Ablation therapy
  • Hepatocellular carcinoma
  • Liver damage
  • Stereotactic radiotherapy
  • Transarterial chemoembolization

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Hypofractionated stereotactic radiotherapy with and without transarterial chemoembolization for small hepatocellular carcinoma not eligible for other ablation therapies : Preliminary results for efficacy and toxicity. / Takeda, Atsuya; Takahashi, Masahiko; Kunieda, Etsuo; Takeda, Toshiaki; Sanuki, Naoko; Koike, Yuji; Atsukawa, Kazuhiro; Ohashi, Toshio; Saito, Hidetsugu; Shigematsu, Naoyuki; Kubo, Atsushi.

In: Hepatology Research, Vol. 38, No. 1, 01.2008, p. 60-69.

Research output: Contribution to journalArticle

@article{ff497e6ce47747c6a8d06d63a855363e,
title = "Hypofractionated stereotactic radiotherapy with and without transarterial chemoembolization for small hepatocellular carcinoma not eligible for other ablation therapies: Preliminary results for efficacy and toxicity",
abstract = "Aim: To investigate the efficacy and toxicity of hypofractionated stereotactic radiotherapy for the treatment of patients presenting with hepatocellular carcinoma (HCC) in a single institutional setting. Methods: Sixteen patients who presented with solitary HCC, including two patients with a tumor thrombus of the portal veins, were treated with stereotactic radiotherapy with or without transarterial chemoembolization. The criteria for stereotactic radiotherapy were existence of technical difficulties for other ablation therapies, inoperable disease or refusal to undergo surgery, tumor staged as Grade A or B according to the Child-Pugh classification, and solitary tumor distant from the gastrointestinal tract and kidney with a tumor volume <100 cm 3. In 14 of 16 patients, a total dose of 35-50 Gy was delivered in 5-7 fractions over 5-9 days. Results: At the end of a mean follow-up of 612 days (median 611 days; range 244-994 days), all patients were alive. Eight of 16 patients had complete responses and seven others were judged as stable with lipiodol accumulation. In one patient, local recurrence developed after 489 days. Intrahepatic recurrences developed outside the treated volume in six patients and no extrahepatic metastases developed during follow-up. No serious treatment-related toxic manifestations developed. Conclusions: Stereotactic radiotherapy for HCC with or without transarterial chemoembolization is feasible therapy and provides good local control with a short treatment period. Stereotactic radiotherapy may be of clinical benefit in patients who are inoperable or for whom there are difficulties in other ablation therapies.",
keywords = "Ablation therapy, Hepatocellular carcinoma, Liver damage, Stereotactic radiotherapy, Transarterial chemoembolization",
author = "Atsuya Takeda and Masahiko Takahashi and Etsuo Kunieda and Toshiaki Takeda and Naoko Sanuki and Yuji Koike and Kazuhiro Atsukawa and Toshio Ohashi and Hidetsugu Saito and Naoyuki Shigematsu and Atsushi Kubo",
year = "2008",
month = "1",
doi = "10.1111/j.1872-034X.2007.00084.x",
language = "English",
volume = "38",
pages = "60--69",
journal = "Hepatology Research",
issn = "1386-6346",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "1",

}

TY - JOUR

T1 - Hypofractionated stereotactic radiotherapy with and without transarterial chemoembolization for small hepatocellular carcinoma not eligible for other ablation therapies

T2 - Preliminary results for efficacy and toxicity

AU - Takeda, Atsuya

AU - Takahashi, Masahiko

AU - Kunieda, Etsuo

AU - Takeda, Toshiaki

AU - Sanuki, Naoko

AU - Koike, Yuji

AU - Atsukawa, Kazuhiro

AU - Ohashi, Toshio

AU - Saito, Hidetsugu

AU - Shigematsu, Naoyuki

AU - Kubo, Atsushi

PY - 2008/1

Y1 - 2008/1

N2 - Aim: To investigate the efficacy and toxicity of hypofractionated stereotactic radiotherapy for the treatment of patients presenting with hepatocellular carcinoma (HCC) in a single institutional setting. Methods: Sixteen patients who presented with solitary HCC, including two patients with a tumor thrombus of the portal veins, were treated with stereotactic radiotherapy with or without transarterial chemoembolization. The criteria for stereotactic radiotherapy were existence of technical difficulties for other ablation therapies, inoperable disease or refusal to undergo surgery, tumor staged as Grade A or B according to the Child-Pugh classification, and solitary tumor distant from the gastrointestinal tract and kidney with a tumor volume <100 cm 3. In 14 of 16 patients, a total dose of 35-50 Gy was delivered in 5-7 fractions over 5-9 days. Results: At the end of a mean follow-up of 612 days (median 611 days; range 244-994 days), all patients were alive. Eight of 16 patients had complete responses and seven others were judged as stable with lipiodol accumulation. In one patient, local recurrence developed after 489 days. Intrahepatic recurrences developed outside the treated volume in six patients and no extrahepatic metastases developed during follow-up. No serious treatment-related toxic manifestations developed. Conclusions: Stereotactic radiotherapy for HCC with or without transarterial chemoembolization is feasible therapy and provides good local control with a short treatment period. Stereotactic radiotherapy may be of clinical benefit in patients who are inoperable or for whom there are difficulties in other ablation therapies.

AB - Aim: To investigate the efficacy and toxicity of hypofractionated stereotactic radiotherapy for the treatment of patients presenting with hepatocellular carcinoma (HCC) in a single institutional setting. Methods: Sixteen patients who presented with solitary HCC, including two patients with a tumor thrombus of the portal veins, were treated with stereotactic radiotherapy with or without transarterial chemoembolization. The criteria for stereotactic radiotherapy were existence of technical difficulties for other ablation therapies, inoperable disease or refusal to undergo surgery, tumor staged as Grade A or B according to the Child-Pugh classification, and solitary tumor distant from the gastrointestinal tract and kidney with a tumor volume <100 cm 3. In 14 of 16 patients, a total dose of 35-50 Gy was delivered in 5-7 fractions over 5-9 days. Results: At the end of a mean follow-up of 612 days (median 611 days; range 244-994 days), all patients were alive. Eight of 16 patients had complete responses and seven others were judged as stable with lipiodol accumulation. In one patient, local recurrence developed after 489 days. Intrahepatic recurrences developed outside the treated volume in six patients and no extrahepatic metastases developed during follow-up. No serious treatment-related toxic manifestations developed. Conclusions: Stereotactic radiotherapy for HCC with or without transarterial chemoembolization is feasible therapy and provides good local control with a short treatment period. Stereotactic radiotherapy may be of clinical benefit in patients who are inoperable or for whom there are difficulties in other ablation therapies.

KW - Ablation therapy

KW - Hepatocellular carcinoma

KW - Liver damage

KW - Stereotactic radiotherapy

KW - Transarterial chemoembolization

UR - http://www.scopus.com/inward/record.url?scp=36549063071&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36549063071&partnerID=8YFLogxK

U2 - 10.1111/j.1872-034X.2007.00084.x

DO - 10.1111/j.1872-034X.2007.00084.x

M3 - Article

VL - 38

SP - 60

EP - 69

JO - Hepatology Research

JF - Hepatology Research

SN - 1386-6346

IS - 1

ER -