TY - JOUR
T1 - MRI-guided stereotactic radiation therapy for hepatocellular carcinoma
T2 - a feasible and safe innovative treatment approach
AU - Boldrini, Luca
AU - Romano, Angela
AU - Mariani, Silvia
AU - Cusumano, Davide
AU - Catucci, Francesco
AU - Placidi, Lorenzo
AU - Mattiucci, Gian Carlo
AU - Chiloiro, Giuditta
AU - Cellini, Francesco
AU - Gambacorta, Maria Antonietta
AU - Indovina, Luca
AU - Valentini, Vincenzo
N1 - Publisher Copyright:
© 2021, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/7
Y1 - 2021/7
N2 - Purpose: Hepatocellular carcinoma (HCC) in early stages benefits from local ablative treatments such as radiofrequency ablation (RFA) or transarterial chemoembolization (TACE). In this context, radiotherapy (RT) has shown promising results but has not been thoroughly evaluated. Magnetic resonance-guided RT (MRgRT) may represent a paradigm shifting improvement in stereotactic body radiotherapy (SBRT) for liver tumors. Methods: We retrospectively evaluated HCC patients treated on a hybrid low-tesla MRgRT unit. A total biologically effective dose (BED) > 100 Gy was delivered in 5 consecutive fractions, respecting the appropriate organs-at-risk constraints. Hybrid MR scans were used for treatment planning and cine MR was used for delivery gating. Patients were followed up for toxicity and treatment–response assessment. Results: Ten patients were enrolled, with a total of 12 lesions. All the lesions were irradiated with no interruptions. Six patients had already performed previous local therapies. Median follow-up after SBRT was 6.5 months (1–25). Two cases of acute toxicity were reported (G ≤ 2 according to CTCAE v4.0). At the time of the analysis, 90% of the population presented local control. Child–Pugh before and after treatment remained unchanged in all but one patient. Conclusion: MRgRT is a feasible and safe option showing favorable toxicity profile for HCC treatment.
AB - Purpose: Hepatocellular carcinoma (HCC) in early stages benefits from local ablative treatments such as radiofrequency ablation (RFA) or transarterial chemoembolization (TACE). In this context, radiotherapy (RT) has shown promising results but has not been thoroughly evaluated. Magnetic resonance-guided RT (MRgRT) may represent a paradigm shifting improvement in stereotactic body radiotherapy (SBRT) for liver tumors. Methods: We retrospectively evaluated HCC patients treated on a hybrid low-tesla MRgRT unit. A total biologically effective dose (BED) > 100 Gy was delivered in 5 consecutive fractions, respecting the appropriate organs-at-risk constraints. Hybrid MR scans were used for treatment planning and cine MR was used for delivery gating. Patients were followed up for toxicity and treatment–response assessment. Results: Ten patients were enrolled, with a total of 12 lesions. All the lesions were irradiated with no interruptions. Six patients had already performed previous local therapies. Median follow-up after SBRT was 6.5 months (1–25). Two cases of acute toxicity were reported (G ≤ 2 according to CTCAE v4.0). At the time of the analysis, 90% of the population presented local control. Child–Pugh before and after treatment remained unchanged in all but one patient. Conclusion: MRgRT is a feasible and safe option showing favorable toxicity profile for HCC treatment.
KW - Hepatocellular carcinoma
KW - Magnetic resonance-guided radiotherapy
KW - Multimodality treatment
KW - Radiotherapy
KW - Stereotactic body radiotherapy
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U2 - 10.1007/s00432-020-03480-8
DO - 10.1007/s00432-020-03480-8
M3 - Article
C2 - 33398447
AN - SCOPUS:85098769531
SN - 0171-5216
VL - 147
SP - 2057
EP - 2068
JO - Journal of Cancer Research and Clinical Oncology
JF - Journal of Cancer Research and Clinical Oncology
IS - 7
ER -