An initial report of CyberKnife stereotactic body radiotherapy in treatment of small hepatocellular carcinoma:a pilot study
10.3760/cma.j.issn.0254-5098.2017.11.008
- VernacularTitle:射波刀治疗小肝癌前瞻性临床研究初步结果
- Author:
Xianzhi ZHAO
1
;
Huojun ZHANG
;
Xiaoyan WANG
;
Zhitao DAI
;
Xiaofei ZHU
;
Shuiwang QING
;
Xiaoping JU
;
Yongming LIU
Author Information
1. 200433,上海长海医院放疗科
- Keywords:
Small hepatocellular carcinoma;
CyberKnife;
Stereotactic body radiotherapy;
Efficacy;
Adverse reactions
- From:
Chinese Journal of Radiological Medicine and Protection
2017;37(11):843-849
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the effectiveness and safety of patients treated with stereotactic body radiotherapy ( SBRT ) - CyberKnife for small hepatocellular carcinoma. Methods A prospective analysis of treatment details and outcomes for 33 patients with small hepatocellular carcinoma treated by CyberKnife at CyberKnife center of Shanghai Changhai Hospital from June 2014 to December 2016 was presented. Patients were followed every 3 months. WHO modified response evaluation criteria in solid Tumors( mRECIST) was used to evaluate efficacy, Common Terminology Criteria for Adverse Events Version 4. 0(CTCAE 4. 0) to evaluate treatment response, Kaplan-Meier method to calculate survival rate and local control rate and plot survival curves. Results There were 33 patients, 33 targets included in the study at the date of the last follow-up. 18 lesions (54. 5%) showed complete remission response, 7 lesions (21. 2%) showed partial remission response, 5 lesions (15. 2%) showed stable, and 3 lesions (9. 1%) progressed. Response rate was 75. 8%, and disease control rate was 90. 9%. 1- and 2-year local control rate was 100% and 83. 6%, respectively. The median disease progression free survival ( DPFS) was 15. 0 months. Non irradiated liver volume more than 100 ml, prior AFP less than 100 ng/ml, post-treatment CTCAE less than grade 2 could improve overall survival ( OS ) . V5 was a factor in grades 2 -4 hepatic toxicity ( P=0. 015 ) . All patients tolerated the radiosurgery, with grade 1 and grade 2 fatigue, and the gastrointestinal reactions and liver injury was the main side effect. 1 patient with grade 3 liver damage relieved at 6 months after treatment and 1 patient with grade 4 liver damage cured at 12 months after treatment. No grade 5 toxicity was encountered. Conclusions CyberKnife seems to be a safe and effective treatment measure with tolerated adverse reaction and good local control rate for patients with small hepatocellular carcinoma.
