Low Hepatic Toxicity in Primary and Metastatic Liver Cancers after Stereotactic Ablative Radiotherapy Using 3 Fractions.
10.3346/jkms.2015.30.8.1055
- Author:
Sun Hyun BAE
1
;
Mi Sook KIM
;
Won Il JANG
;
Chul Koo CHO
;
Hyung Jun YOO
;
Kum Bae KIM
;
Chul Ju HAN
;
Su Cheol PARK
;
Dong Han LEE
Author Information
1. Department of Radiation Oncology, Soonchunhyang University College of Medicine, Bucheon, Korea.
- Publication Type:Clinical Trial ; Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Child-Pugh Score;
Liver Neoplasms;
Hepatic Toxicity;
Predictor;
Stereotactic Body Radiotherapy
- MeSH:
Aged;
*Dose Fractionation;
Female;
Hepatitis/*etiology/pathology/prevention & control;
Humans;
Liver Neoplasms/complications/pathology/*surgery;
Male;
Middle Aged;
Neoplasm Metastasis;
Radiation Injuries/*etiology/pathology/prevention & control;
Radiosurgery/*adverse effects/*methods;
Radiotherapy Dosage;
Treatment Outcome
- From:Journal of Korean Medical Science
2015;30(8):1055-1061
- CountryRepublic of Korea
- Language:English
-
Abstract:
This study evaluated the incidence of hepatic toxicity after stereotactic ablative radiotherapy (SABR) using 3 fractions to the liver, and identified the predictors for hepatic toxicity. We retrospectively reviewed 78 patients with primary and metastatic liver cancers, who underwent SABR using 3 fractions between 2003 and 2011. To examine the incidence of hepatic toxicity, we defined newly developed hepatic toxicity> or =grade 2 according to the National Cancer Institute Common Terminology Criteria for Adverse Events v4.0 within 3 months after the end of SABR as a significant adverse event. To identify the predictors for hepatic toxicity, we analyzed several clinical and dosimetric parameters (rV(5Gy)-rV(35Gy): normal liver volume receiving or =grade 2 occurred in 10 patients (13%): grade 2 in 9 patients and grade 3 in 1 patient. On univariate analysis, baseline Child-Pugh (CP) score (5 vs. 6-8), normal liver volume, and planning target volume were the significant clinical predictors. All dosimetric parameters were significant: rV(20Gy) was the most significant predictor. On multivariate analysis, baseline CP score (hazard ratio, 0.026; P=0.001) was the only significant predictor. In conclusion, SABR using 3 fractions in primary and metastatic liver cancers produces low hepatic toxicity, especially in patients with a baseline CP score of 5. However, further studies are needed to minimize hepatic toxicity in patients with baseline CP scores> or =6.
