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Feasibility of stereotactic body radiation therapy with volumetric modulated arc therapy and high intensity photon beams for hepatocellular carcinoma patients
To report technical features, early outcome and toxicity of stereotactic body radiation therapy (SBRT) treatments with volumetric modulated arc therapy (RapidArc) for patients with hepatocellular carcinoma (HCC). Twenty patients (22 lesions) were prospectively enrolled in a feasibility study. Dose p...
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Published in: | Radiation oncology (London, England) England), 2014-01, Vol.9 (1), p.18-18, Article 18 |
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description | To report technical features, early outcome and toxicity of stereotactic body radiation therapy (SBRT) treatments with volumetric modulated arc therapy (RapidArc) for patients with hepatocellular carcinoma (HCC).
Twenty patients (22 lesions) were prospectively enrolled in a feasibility study. Dose prescription was 50 Gy in 10 fractions. Seven patients (35%) were classified as AJCC stage I-II while 13 (65%) were stages III-IV. Eighteen patients (90%) were Child-Pugh stage A, the remaining were stage B. All patients were treated with RapidArc technique with flattening filter free (FFF) photon beams of 10 MV from a TrueBeam linear accelerator. Technical, dosimetric and early clinical assessment was performed to characterize treatment and its potential outcome.
Median age was 68 years, median initial tumor volume was 124 cm3 (range: 6-848). Median follow-up time was 7.4 months (range: 3-13). All patients completed treatment without interruption. Mean actuarial overall survival was of 9.6 ± 0.9 months (95%C.L. 7.8-11.4), median survival was not reached; complete response was observed in 8/22 (36.4%) lesions; partial response in 7/22 (31.8%), stable disease in 6/22 (27.3%), 1/22 (4.4%) showed progression. Toxicity was mild with only 1 case of grade 3 RILD and all other types were not greater than grade 2. Concerning dosimetric data, Paddick conformity index was 0.98 ± 0.02; gradient index was 3.82 ± 0.93; V95% to the clinical target volume was 93.6 ± 7.7%. Mean dose to kidneys resulted lower than 3.0 Gy; mean dose to stomach 4.5 ± 3.0 Gy; D(3) 1(cm) to spinal cord was 8.2 ± 4.5 Gy; D1% to the esophagus was 10.2 ± 9.7 Gy. Average beam on time resulted 0.7 ± 0.2 minutes (range: 0.4-1.4) with the delivery of an average of 4.4 partial arcs (range: 3-6) of those 86% non-coplanar.
Clinical results could suggest to introduce VMAT-RapidArc as an appropriate SBRT technique for patients with HCC in view of a prospective dose escalation trial. |
doi_str_mv | 10.1186/1748-717X-9-18 |
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Twenty patients (22 lesions) were prospectively enrolled in a feasibility study. Dose prescription was 50 Gy in 10 fractions. Seven patients (35%) were classified as AJCC stage I-II while 13 (65%) were stages III-IV. Eighteen patients (90%) were Child-Pugh stage A, the remaining were stage B. All patients were treated with RapidArc technique with flattening filter free (FFF) photon beams of 10 MV from a TrueBeam linear accelerator. Technical, dosimetric and early clinical assessment was performed to characterize treatment and its potential outcome.
Median age was 68 years, median initial tumor volume was 124 cm3 (range: 6-848). Median follow-up time was 7.4 months (range: 3-13). All patients completed treatment without interruption. Mean actuarial overall survival was of 9.6 ± 0.9 months (95%C.L. 7.8-11.4), median survival was not reached; complete response was observed in 8/22 (36.4%) lesions; partial response in 7/22 (31.8%), stable disease in 6/22 (27.3%), 1/22 (4.4%) showed progression. Toxicity was mild with only 1 case of grade 3 RILD and all other types were not greater than grade 2. Concerning dosimetric data, Paddick conformity index was 0.98 ± 0.02; gradient index was 3.82 ± 0.93; V95% to the clinical target volume was 93.6 ± 7.7%. Mean dose to kidneys resulted lower than 3.0 Gy; mean dose to stomach 4.5 ± 3.0 Gy; D(3) 1(cm) to spinal cord was 8.2 ± 4.5 Gy; D1% to the esophagus was 10.2 ± 9.7 Gy. Average beam on time resulted 0.7 ± 0.2 minutes (range: 0.4-1.4) with the delivery of an average of 4.4 partial arcs (range: 3-6) of those 86% non-coplanar.
Clinical results could suggest to introduce VMAT-RapidArc as an appropriate SBRT technique for patients with HCC in view of a prospective dose escalation trial.</description><identifier>ISSN: 1748-717X</identifier><identifier>EISSN: 1748-717X</identifier><identifier>DOI: 10.1186/1748-717X-9-18</identifier><identifier>PMID: 24410988</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - radiotherapy ; Carcinoma, Hepatocellular - surgery ; Care and treatment ; Cohort Studies ; Combined Modality Therapy ; Feasibility Studies ; Female ; Health aspects ; Hepatoma ; Humans ; Liver Neoplasms - pathology ; Liver Neoplasms - radiotherapy ; Liver Neoplasms - surgery ; Male ; Medical research ; Medicine, Experimental ; Middle Aged ; Organs at Risk - pathology ; Organs at Risk - radiation effects ; Patient outcomes ; Photons - adverse effects ; Photons - therapeutic use ; Radiation ; Radiosurgery - adverse effects ; Radiotherapy ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated - adverse effects ; Radiotherapy, Intensity-Modulated - methods</subject><ispartof>Radiation oncology (London, England), 2014-01, Vol.9 (1), p.18-18, Article 18</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Wang et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Copyright © 2014 Wang et al.; licensee BioMed Central Ltd. 2014 Wang et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b543t-82acfbb3bbfc7b195b562d7a8d77306f51af669b468943aebcebea08d322f69a3</citedby><cites>FETCH-LOGICAL-b543t-82acfbb3bbfc7b195b562d7a8d77306f51af669b468943aebcebea08d322f69a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940026/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1504311365?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24410988$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Po-Ming</creatorcontrib><creatorcontrib>Hsu, Wei-Chung</creatorcontrib><creatorcontrib>Chung, Na-Na</creatorcontrib><creatorcontrib>Chang, Feng-Ling</creatorcontrib><creatorcontrib>Jang, Chin-Jyh</creatorcontrib><creatorcontrib>Fogliata, Antonella</creatorcontrib><creatorcontrib>Scorsetti, Marta</creatorcontrib><creatorcontrib>Cozzi, Luca</creatorcontrib><title>Feasibility of stereotactic body radiation therapy with volumetric modulated arc therapy and high intensity photon beams for hepatocellular carcinoma patients</title><title>Radiation oncology (London, England)</title><addtitle>Radiat Oncol</addtitle><description>To report technical features, early outcome and toxicity of stereotactic body radiation therapy (SBRT) treatments with volumetric modulated arc therapy (RapidArc) for patients with hepatocellular carcinoma (HCC).
Twenty patients (22 lesions) were prospectively enrolled in a feasibility study. Dose prescription was 50 Gy in 10 fractions. Seven patients (35%) were classified as AJCC stage I-II while 13 (65%) were stages III-IV. Eighteen patients (90%) were Child-Pugh stage A, the remaining were stage B. All patients were treated with RapidArc technique with flattening filter free (FFF) photon beams of 10 MV from a TrueBeam linear accelerator. Technical, dosimetric and early clinical assessment was performed to characterize treatment and its potential outcome.
Median age was 68 years, median initial tumor volume was 124 cm3 (range: 6-848). Median follow-up time was 7.4 months (range: 3-13). All patients completed treatment without interruption. Mean actuarial overall survival was of 9.6 ± 0.9 months (95%C.L. 7.8-11.4), median survival was not reached; complete response was observed in 8/22 (36.4%) lesions; partial response in 7/22 (31.8%), stable disease in 6/22 (27.3%), 1/22 (4.4%) showed progression. Toxicity was mild with only 1 case of grade 3 RILD and all other types were not greater than grade 2. Concerning dosimetric data, Paddick conformity index was 0.98 ± 0.02; gradient index was 3.82 ± 0.93; V95% to the clinical target volume was 93.6 ± 7.7%. Mean dose to kidneys resulted lower than 3.0 Gy; mean dose to stomach 4.5 ± 3.0 Gy; D(3) 1(cm) to spinal cord was 8.2 ± 4.5 Gy; D1% to the esophagus was 10.2 ± 9.7 Gy. Average beam on time resulted 0.7 ± 0.2 minutes (range: 0.4-1.4) with the delivery of an average of 4.4 partial arcs (range: 3-6) of those 86% non-coplanar.
Clinical results could suggest to introduce VMAT-RapidArc as an appropriate SBRT technique for patients with HCC in view of a prospective dose escalation trial.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - radiotherapy</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Care and treatment</subject><subject>Cohort Studies</subject><subject>Combined Modality Therapy</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hepatoma</subject><subject>Humans</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - radiotherapy</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Organs at Risk - pathology</subject><subject>Organs at Risk - radiation effects</subject><subject>Patient outcomes</subject><subject>Photons - adverse effects</subject><subject>Photons - therapeutic use</subject><subject>Radiation</subject><subject>Radiosurgery - adverse effects</subject><subject>Radiotherapy</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Intensity-Modulated - adverse effects</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><issn>1748-717X</issn><issn>1748-717X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNp1kk1rFTEUhgdRbK1uXUrA9dRkkslkNsKlWBUKbhTchZOvOykzyTXJVO6f8beaS-u1xUoWCee858mbnNM0rwk-J0Twd2Rgoh3I8L0dWyKeNKfHwNN755PmRc7XGLOe4vF5c9IxRvAoxGnz69JC9srPvuxRdCgXm2wsoIvXSEWzRwmMh-JjQGWyCXZ79NOXCd3EeV1sSVW2RLPOUKxBkPRRBcGgyW8n5EOxIR_4uymWylEWloxcTGiyOyhR23mugIR0rfchLoBq2NtQ8svmmYM521d3-1nz7fLD14tP7dWXj58vNlet6hktrehAO6WoUk4Pioy96nlnBhBmGCjmrifgOB8V42JkFKzStprAwtCuc3wEeta8v-XuVrVYo-vdCWa5S36BtJcRvHyYCX6S23gj6cgw7ngFbG4Bysf_AB5mdFzkoT_y0B85SiIq4-2diRR_rDYXeR3XFOq7Jekxo4RQ3v9VbWG20gcXK08vPmu56RnmrMMdq6rzR1R1Gbt4HYN1vsYfK9Ap5pysO3onWB5G7V-3b-5_2VH-Z7bob1Mq1Tc</recordid><startdate>20140110</startdate><enddate>20140110</enddate><creator>Wang, Po-Ming</creator><creator>Hsu, Wei-Chung</creator><creator>Chung, Na-Na</creator><creator>Chang, Feng-Ling</creator><creator>Jang, Chin-Jyh</creator><creator>Fogliata, Antonella</creator><creator>Scorsetti, Marta</creator><creator>Cozzi, Luca</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>5PM</scope></search><sort><creationdate>20140110</creationdate><title>Feasibility of stereotactic body radiation therapy with volumetric modulated arc therapy and high intensity photon beams for hepatocellular carcinoma patients</title><author>Wang, Po-Ming ; Hsu, Wei-Chung ; Chung, Na-Na ; Chang, Feng-Ling ; Jang, Chin-Jyh ; Fogliata, Antonella ; Scorsetti, Marta ; Cozzi, Luca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b543t-82acfbb3bbfc7b195b562d7a8d77306f51af669b468943aebcebea08d322f69a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - radiotherapy</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Care and treatment</topic><topic>Cohort Studies</topic><topic>Combined Modality Therapy</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Health aspects</topic><topic>Hepatoma</topic><topic>Humans</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - radiotherapy</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Organs at Risk - pathology</topic><topic>Organs at Risk - radiation effects</topic><topic>Patient outcomes</topic><topic>Photons - adverse effects</topic><topic>Photons - therapeutic use</topic><topic>Radiation</topic><topic>Radiosurgery - adverse effects</topic><topic>Radiotherapy</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Intensity-Modulated - adverse effects</topic><topic>Radiotherapy, Intensity-Modulated - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Po-Ming</creatorcontrib><creatorcontrib>Hsu, Wei-Chung</creatorcontrib><creatorcontrib>Chung, Na-Na</creatorcontrib><creatorcontrib>Chang, Feng-Ling</creatorcontrib><creatorcontrib>Jang, Chin-Jyh</creatorcontrib><creatorcontrib>Fogliata, Antonella</creatorcontrib><creatorcontrib>Scorsetti, Marta</creatorcontrib><creatorcontrib>Cozzi, Luca</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Radiation oncology (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Po-Ming</au><au>Hsu, Wei-Chung</au><au>Chung, Na-Na</au><au>Chang, Feng-Ling</au><au>Jang, Chin-Jyh</au><au>Fogliata, Antonella</au><au>Scorsetti, Marta</au><au>Cozzi, Luca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility of stereotactic body radiation therapy with volumetric modulated arc therapy and high intensity photon beams for hepatocellular carcinoma patients</atitle><jtitle>Radiation oncology (London, England)</jtitle><addtitle>Radiat Oncol</addtitle><date>2014-01-10</date><risdate>2014</risdate><volume>9</volume><issue>1</issue><spage>18</spage><epage>18</epage><pages>18-18</pages><artnum>18</artnum><issn>1748-717X</issn><eissn>1748-717X</eissn><abstract>To report technical features, early outcome and toxicity of stereotactic body radiation therapy (SBRT) treatments with volumetric modulated arc therapy (RapidArc) for patients with hepatocellular carcinoma (HCC).
Twenty patients (22 lesions) were prospectively enrolled in a feasibility study. Dose prescription was 50 Gy in 10 fractions. Seven patients (35%) were classified as AJCC stage I-II while 13 (65%) were stages III-IV. Eighteen patients (90%) were Child-Pugh stage A, the remaining were stage B. All patients were treated with RapidArc technique with flattening filter free (FFF) photon beams of 10 MV from a TrueBeam linear accelerator. Technical, dosimetric and early clinical assessment was performed to characterize treatment and its potential outcome.
Median age was 68 years, median initial tumor volume was 124 cm3 (range: 6-848). Median follow-up time was 7.4 months (range: 3-13). All patients completed treatment without interruption. Mean actuarial overall survival was of 9.6 ± 0.9 months (95%C.L. 7.8-11.4), median survival was not reached; complete response was observed in 8/22 (36.4%) lesions; partial response in 7/22 (31.8%), stable disease in 6/22 (27.3%), 1/22 (4.4%) showed progression. Toxicity was mild with only 1 case of grade 3 RILD and all other types were not greater than grade 2. Concerning dosimetric data, Paddick conformity index was 0.98 ± 0.02; gradient index was 3.82 ± 0.93; V95% to the clinical target volume was 93.6 ± 7.7%. Mean dose to kidneys resulted lower than 3.0 Gy; mean dose to stomach 4.5 ± 3.0 Gy; D(3) 1(cm) to spinal cord was 8.2 ± 4.5 Gy; D1% to the esophagus was 10.2 ± 9.7 Gy. Average beam on time resulted 0.7 ± 0.2 minutes (range: 0.4-1.4) with the delivery of an average of 4.4 partial arcs (range: 3-6) of those 86% non-coplanar.
Clinical results could suggest to introduce VMAT-RapidArc as an appropriate SBRT technique for patients with HCC in view of a prospective dose escalation trial.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>24410988</pmid><doi>10.1186/1748-717X-9-18</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Aged, 80 and over Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - radiotherapy Carcinoma, Hepatocellular - surgery Care and treatment Cohort Studies Combined Modality Therapy Feasibility Studies Female Health aspects Hepatoma Humans Liver Neoplasms - pathology Liver Neoplasms - radiotherapy Liver Neoplasms - surgery Male Medical research Medicine, Experimental Middle Aged Organs at Risk - pathology Organs at Risk - radiation effects Patient outcomes Photons - adverse effects Photons - therapeutic use Radiation Radiosurgery - adverse effects Radiotherapy Radiotherapy Dosage Radiotherapy, Intensity-Modulated - adverse effects Radiotherapy, Intensity-Modulated - methods |
title | Feasibility of stereotactic body radiation therapy with volumetric modulated arc therapy and high intensity photon beams for hepatocellular carcinoma patients |
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