TITLE

Robotic radiosurgery treatment in liver tumours: early experience from an indian centre

AUTHOR(S)
Dutta, D.; S. H.; Balaji, S.; Jayaraj, G.; Kurup, P.; Murli, V.
PUB. DATE
March 2013
SOURCE
Journal of Radiosurgery & SBRT;2013 Supplement 2.1, Vol. 2, p112
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: We report initial experience with SBRT in patients hepatocellular carcinoma (HCC), liver metastasis (LM) and Klastkin tumour (KT). Methods: Seventeen consecutive patients (mean age 57.5 years, range 35-81 yrs; 82% male) treated with fiducial based robotic radiosurgery. Nine patients had HCC (n=9) and four each had LM (n=4) and KT (n=4). 11/17 patient (70%) were with Child Pugh A/B, 8/9 with HCC had infective hepatitis (4 each with hepatitis B & C), 5/17 (29%) had diffuse cirrhosis, 70%(12/17) had single lesion in liver and target volume <10cc in 3 patient (17%), 11-90cc in 8 (47%) and >90 cc in 6 (35%) patients respectively. 13/17 (75%) patients had prior treatment [chemotherapy 8/13 (61%), TACE 5/13 (39%)] and treated with SBRT on progression. All patients were treated with 3 fractions (21-45Gy/3#; mean dose 33Gy, prescription isodose 84%, target coverage 94%); fiducial tracking based CyberKnife. Mean CI, nCI, HI was 1.13, 1.28 and 1.19 respectively. Mean liver dose was 4.7 Gy, 800cc liver dose 8.2 Gy; 2% small intestine dose 10.6 Gy. Mean nodes, beamlets, monitor units and treatment time 69, 174, 46919 and 60.4 min respectively. Results: At mean follow up of 11.3 months (range 1.9-26.5), 12/17 (70%) patients expired and 5/17 (30%) alive (3 patient with controlled primary, one each with local progression and metastasis). Median overall survival (OS) in HCC patients was 11.9 months (2.1-26.5 months), MT 8.3 months (1.9-13.3 months) and KT was 12.8 months (7.4-25 months) respectively. 5/17 (30%) patients had grade I-II GI toxicities, no grade III-IV toxicities were observed and only one patient (12%) had anicteric ascites with high serum alkaline phosphatase two months after CK and recovered with supportive care. Median OS (month) were significantly influenced by factors such as performance status (KPS 70-80 vs 90-100: 8.3 vs 15.4; p=0.034), Child Pugh (CP A/B vs C: 13.3 vs 4.9; p=0.039), cirrhosis (only fatty liver vs diffuse cirrhosis: 13.3 vs 9.4; p=0.005), prior treatment (no Rx vs prior Rx: 16.6 vs 8.3; p=0.006), dose (<39Gy vs >39Gy: 9.5 vs 15.4; p=0.02) and target volume (<10cc vs >90 cc: 15.7 vs 7.7; p=0.011) respectively. There was no fiducial related toxicity or migration. Conclusion. SBRT is safe and effective local treatment modality in selected patients with liver malignancies with minimal adverse events. Factors such as performace status, Child Pugh classification, cirrhosis status, prior treatment, RT dose and target volume significantly influence survival function. Disclosure: No significant relationships.
ACCESSION #
92611258

 

Related Articles

  • Integrating respiratory-gated PET-based target volume delineation in liver SBRT planning, a pilot study. Riou, Olivier; Serrano, Benjamin; Azria, David; Paulmier, Benoit; Villeneuve, Remy; Fenoglietto, Pascal; Artenie, Antonella; Ortholan, Cécile; Faraggi, Marc; Thariat, Juliette // Radiation Oncology;2014, Vol. 9 Issue 1, p1 

    Background To assess the feasibility and benefit of integrating four-dimensional (4D) Positron Emission Tomography (PET) - computed tomography (CT) for liver stereotactic body radiation therapy (SBRT) planning. Methods 8 patients with 14 metastases were accrued in the study. They all underwent a...

  • Single-dose radiosurgical treatment for hepatic metastases - therapeutic outcome of 138 treated lesions from a single institution. Habermehl, Daniel; Herfarth, Klaus K.; Lorenzo Bermejo, Justo; Hof, Holger; Rieken, Stefan; Kuhn, Sabine; Welzel, Thomas; Debus, Jürgen; Combs, Stephanie E. // Radiation Oncology;2013, Vol. 8 Issue 1, p1 

    Background: Local ablative therapies such as stereotactically guided single-dose radiotherapy or helical intensitymodulated radiotherapy (tomotherapy) with high single-doses are successfully applied in many centers in patients with liver metastasis not suitable for surgical resection. This study...

  • Hot Saline Coagulation for Hepatoma. Matamoros Jr., A.; Thompson, Jon S. // American Journal of Gastroenterology;Sep1999, Vol. 94 Issue 9, p2342 

    Discusses research being done in using percutaneous hot saline injection therapy in large hepatocellular carcinoma (HCC). Reference to a study by H. K. Yoon, H. Y. Song, K. B. Sung et al., published in the 1999 issue of the "JVIR"; Therapies used for hepatocellular carcinoma; Methodology used;...

  • Radiofrequency Ablation of Hepatic Metastases from Thyroid Carcinoma. Marieke W.J.L.A.E. Wertenbroek; Thera P. Links; Ted R. Prins; John T.M. Plukker; Erik J. van der Jagt; Koert P. de Jong // Thyroid;Oct2008, Vol. 18 Issue 10, p1105 

    Background:Radiofrequency ablation (RFA) is performed for various types of liver tumors. It might also have a role in the palliative treatment of liver metastases from thyroid carcinoma.Summary:Three patients with liver metastases of thyroid carcinoma were retrieved from our database of 125...

  • Robotic-assisted thermal ablation of liver tumours. Abdullah, Basri; Yeong, Chai; Goh, Khean; Yoong, Boon; Ho, Gwo; Yim, Carolyn; Kulkarni, Anjali // European Radiology;Jan2015, Vol. 25 Issue 1, p246 

    Objective: This study aimed to assess the technical success, radiation dose, safety and performance level of liver thermal ablation using a computed tomography (CT)-guided robotic positioning system. Methods: Radiofrequency and microwave ablation of liver tumours were performed on 20 patients...

  • Re-Irradiation of Progressive Brain Metastases After Whole Brain Radiotherapy: Outcome of Stereotactic Radiosurgery. Özşeker, Naciye Işik; Koçak, Mihriban; Mayadağli, Alpaslan; Gemici, Cengiz; Gül, Şule; Gedik, Duygu // Journal of Neurological Sciences;2012, Vol. 29 Issue 1, p82 

    Purpose: In our study, rates of and factors affecting survival obtained by frameless robotic stereotactic radiosurgery are investigated retrospectively in progressive brain metastases previously treated with total cranial radiotherapy. Materials and Methods: SRS was given as salvage therapy to...

  • Robotic radiosurgery for the treatment of one to three brain metastases: a pragmatic application of cost-benefit analysis using willingness-to-pay. Greenspoon, J. N.; Whelan, T.; Whitton, A.; Wright, J.; Sharieff, W.; Gafni, A. // Journal of Radiosurgery & SBRT;2013 Supplement 2.1, Vol. 2, p7 

    Purpose: With the emergence of radiosurgery as a new radiotheraputic technique, health care decision makers are required to incorporate community need, cost and patient preferences when allocating radiosurgery resources. Conventional patient utility measures would not reflect short term...

  • Frameless radiosurgery: less invasive, more accurate? Gevaert, T.; Verellen, D.; De Ridder, M. // Journal of Radiosurgery & SBRT;2013 Supplement 2.1, Vol. 2, p146 

    Purpose: Stereotactic radiosurgery using frame-based positioning is a well-established technique for the treatment of benign and malignant lesions. By contrast, a new trend towards frameless systems using image-guided positioning techniques is gaining mainstream acceptance. This study was...

  • Precision TACE u terapiji primarnih malignih tumora jetre (hepatoceluarnog karcinoma - HCC-a). Bojanović, A.; Bošnjaković, P.; Stojanović, M.; Marković, M.; Mrvić, M.; Radić, S.; Radovanović, Z. // Acta Chirurgica Iugoslavica;2009, Vol. 56 Issue 4, p143 

    AIM: Hepatocellular carcinoma is one of the most frequent malignant tumors in general and most common liver malignancy. Aim of this study was to determine the therapeutic effect of chemoembolization with microspheres charged with doxorubicin in HHC patients. MATERIAL AND METHODS: During for...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics