Stereotactic body radiation therapy in hepatocellular carcinoma and cirrhosis: Evaluation of radiological and pathological response

Journal of Surgical Oncology - Tập 105 Số 7 - Trang 692-698 - 2012
Marcelo Facciuto1,2, Manoj K. Singh2, Caroline Rochon3,4, Jyoti Sharma5, Cecilia Gimenez6, Umadevi S. Katta3,6, Chitti R. Moorthy7,8, Stuart Bentley–Hibbert3,9, Manuel I. Rodríguez-Dávalos10,11, David C. Wolf12,13
1Associate Professor
2Recanati Miller Transplant Institute, Mount Sinai Medical Center, Mount Sinai School of Medicine, New York, New York
3Assistant Professor
4Liver Transplantation and Hepatobiliary Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York
5Department of Surgery, Westchester Medical Center/New York Medical College, Valhalla, New York
6Division of Pathology, Westchester Medical Center, New York Medical College, Valhalla, New York
7Division of Radiation Oncology, Westchester Medical Center, New York Medical College, Valhalla, New York
8Professor of Clinical Radiation Medicine.
9Division of Radiology, Westchester Medical Center, New York Medical College, Valhalla, New York
10Assistant Professor of Surgery and Pediatrics.
11Yale-New Haven Transplantation Center, New Haven, Connecticut
12Division of Gastroenterology and Hepatobiliary Diseases, Westchester Medical Center, New York Medical College, Valhalla, New York
13Professor of Clinical Medicine.

Tóm tắt

AbstractBackgroundLoco‐regional therapies for cirrhotic patients with hepatocellular carcinoma (HCC) who are awaiting liver transplantation (OLT) attempt to prevent tumor progression. However, there is limited data regarding the efficacy of stereotactic body radiation therapy (SBRT) as loco‐regional treatment.MethodsFrom 2006 to 2009, 27 HCC patients (AJCC I, II) listed for OLT underwent SBRT. Thirty‐nine lesions were treated and 27 assessed radiologically. Seventeen patients had OLT, liver explants were analyzed and 22 lesions underwent pathological evaluation.ResultsIn a cumulative analysis of all imaging, 30% had complete response, 7% had partial response, 56% were stable, and 7% had progression of disease. Of the 22 pathologically evaluated lesions, 37% were responders: 14% with complete response, 23% with partial response, and 63% with no response. Side effects from SBRT were recorded in three patients, which included nausea in two and liver decompensation in one.ConclusionSBRT achieves total or partial radiological response in 37% of patients and total or partial pathological response in 37% of patients with early HCC in the setting of cirrhosis. SBRT may be a safe and effective alternative for local tumor control in patients with HCC and cirrhosis awaiting OLT. J. Surg. Oncol. 2012; 105:692–698. © 2011 Wiley Periodicals, Inc.

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Journal of Surgical Oncology

Tập 105 Số 7

692-698

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