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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 5
May  2021
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Article Contents

Application of stereotactic body radiotherapy in small hepatocellular carcinoma

DOI: 10.3969/j.issn.1001-5256.2021.05.050
  • Received Date: 2020-10-08
  • Accepted Date: 2020-11-09
  • Published Date: 2021-05-20
  • At present, hepatic resection (HR) and radiofrequency ablation of (RFA) are the main radical treatment methods for small hepatocellular carcinoma (sHCC), while stereotactic body radiotherapy (SBRT) is developing rapidly and there is an increasing number of reports on the effective treatment of sHCC with SBRT. This article introduces the technical advantages, therapeutic dose, and fractionation scheme of SBRT in the treatment of sHCC, as well as the limit of normal liver tissue and the protection of surrounding organs at risk. This article also compares the efficacy of SBRT versus HR and RFA in the treatment of sHCC and briefly describes the adverse reactions of SBRT in the treatment of sHCC. Previous studies have shown that for some sHCC cases, SBRT has an equal or even better clinical effect than HR and RFA, with controllable toxicity. Therefore, SBRT is expected to become another radical treatment method for sHCC.

     

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  • [1]
    GE WL. Prognostic analysis of regular or irregular hepatectomy for single small hepatocellular carcinoma[J]. J Hepatobiliary Surg, 2017, 25 (3): 181-185. DOI: 10.3969/j.issn.1006-4761.2017.03.007.

    葛万灵. 规则性或非规则性肝癌切除术治疗单发小肝癌的预后分析[J]. 肝胆外科杂志, 2017, 25(3): 181-185. DOI: 10.3969/j.issn.1006-4761.2017.03.007.
    [2]
    HE J, MAO YS, SHEN K, et al. Clinical Oncology[M]. Beijing: People's Health publishing house, 2016: 450. (in Chinese)

    赫捷, 毛友生, 沈铿, 等. 临床肿瘤学[M]. 北京: 人民卫生出版社, 2016: 450.
    [3]
    Medical Administration of the National Health Commission of the people's Republic of China. Standard for diagnosis and treatment of primary liver cancer (2019 Edition)[J]. J Clin Hepatol, 2020, 36 (2): 277-292. DOI: 10.3969/j.issn.1001-5256.2020.02.007.

    中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范(2019年版)[J]. 临床肝胆病杂志, 2020, 36(2): 277-292. DOI: 10.3969/j.issn.1001-5256.2020.02.007.
    [4]
    JEONG Y, JUNG J, CHO B, et al. Stereotactic body radiation therapy using a respiratory-gated volumetric-modulated arc therapy technique for small hepatocellular carcinoma[J]. BMC Cancer, 2018, 18(1): 416. DOI: 10.1186/s12885-018-4340-7.
    [5]
    ZENG ZC, SUN JG, LANG JY. Radiotherapy for hepatocellular carcinoma downstaging: From palliative care to radical treatment[J]. J Clin Hepatol, 2020, 36(2): 258-262. DOI: 10.3969/j.issn.1001-5256.2020.02.003.

    曾昭冲, 孙建国, 郎锦义. 肝细胞癌放疗降期——从姑息走向根治[J]. 临床肝胆病杂志, 2020, 36(2): 258-262. DOI: 10.3969/j.issn.1001-5256.2020.02.003.
    [6]
    ZENG ZC. Stereotactic radiotherapy for liver cancer is a radical method worth exploring[J]. Liver, 2020, 25(7): 665-667. https://www.cnki.com.cn/Article/CJFDTOTAL-ZUAN202007005.htm

    曾昭冲. 肝癌立体定向放疗是值得探索的根治性方法[J]. 肝脏, 2020, 25(7): 665- 667. https://www.cnki.com.cn/Article/CJFDTOTAL-ZUAN202007005.htm
    [7]
    ZENG ZC, SEONG J, YOON SM, et al. Consensus on stereotactic body radiation therapy for small-sized hepatocellular carcinoma at the 7th Asia-Pacific Primary Liver Cancer Expert Meeting[J]. Liver Cancer, 2017, 6(4): 264-274. DOI: 10.1159/000475768.
    [8]
    WANG PM, HSU WC, CHUNG NN, et al. Feasibility of stereotactic body radiation therapy with volumetric modulated arc therapy and high intensity photon beams for hepatocellular carcinoma patients[J]. Radiat Oncol, 2014, 9: 18. DOI: 10.1186/1748-717X-9-18.
    [9]
    ZHANG T, SUN J, HE WP, et al. Clinical effect of CyberKnife stereotactic radiosurgery in treatment of patients with small hepatocellular carcinoma[J]. J Clin Hepatol, 2017, 33(4): 694-698. DOI: 10.3969/j.issn.1001-5256.2017.04.019.

    张弢, 孙静, 何卫平, 等. 射波刀立体定向放射治疗小肝癌的临床效果[J]. 临床肝胆病杂志, 2017, 33(4): 694-698. DOI: 10.3969/j.issn.1001-5256.2017.04.019.
    [10]
    JIN H, CHALKIDOU A, HAWKINS M, et al. Cost-effectiveness analysis of stereotactic ablative body radiation therapy compared with surgery and radiofrequency ablation in two patient cohorts: Metastatic liver cancer and hepatocellular carcinoma[J]. Clin Oncol (R Coll Radiol), 2021, 33(3): e143-e154. DOI: 10.1016/j.clon.2020.08.010.
    [11]
    LU L, DIACONU C, DJEMIL T, et al. Intra- and inter-fractional liver and lung tumor motions treated with SBRT under active breathing control[J]. J Appl Clin Med Phys, 2018, 19(1): 39-45. DOI: 10.1002/acm2.12220.
    [12]
    HU Y, ZHOU YK, CHEN YX, et al. 4D-CT scans reveal reduced magnitude of respiratory liver motion achieved by different abdominal compression plate positions in patients with intrahepatic tumors undergoing helical tomotherapy[J]. Med Phys, 2016, 43(7): 4335. DOI: 10.1118/1.4953190.
    [13]
    CHEN YX, ZHUANG Y, YANG P, et al. Helical IMRT-based stereotactic body radiation therapy using an abdominal compression technique and modified fractionation regimen for small hepatocellular carcinoma[J]. Technol Cancer Res Treat, 2020, 19: 1533033820937002. DOI: 10.1177/1533033820937002.
    [14]
    YOON SM, KIM SY, LIM YS, et al. Stereotactic body radiation therapy for small (≤5 cm) hepatocellular carcinoma not amenable to curative treatment: Results of a single-arm, phase Ⅱ clinical trial[J]. Clin Mol Hepatol, 2020, 26(4): 506-515. DOI: 10.3350/cmh.2020.0038.
    [15]
    GKIKA E, TANADINI-LANG S, KIRSTE S, et al. Interobserver variability in target volume delineation of hepatocellular carcinoma: An analysis of the working group "Stereotactic Radiotherapy" of the German Society for Radiation Oncology (DEGRO)[J]. Strahlenther Onkol, 2017, 193(10): 823-830. DOI: 10.1007/s00066-017-1177-y.
    [16]
    SHETH N, OSBORN V, LEE A, et al. Stereotactic ablative radiotherapy fractionation for hepatocellular carcinoma in the United States[J]. Cureus, 2020, 12(6): e8675. DOI: 10.7759/cureus.8675.
    [17]
    PARK HC, SEONG J, HAN KH, et al. Dose-response relationship in local radiotherapy for hepatocellular carcinoma[J]. Int J Radiat Oncol Biol Phys, 2002, 54(1): 150-155. DOI: 10.1016/s0360-3016(02)02864-x.
    [18]
    SUN J, ZHANG T, WANG J, et al. Biologically effective dose (BED) of stereotactic body radiation therapy (SBRT) was an important factor of therapeutic efficacy in patients with hepatocellular carcinoma (≤5 cm)[J]. BMC Cancer, 2019, 19(1): 846. DOI: 10.1186/s12885-019-6063-9.
    [19]
    PARK S, JUNG J, CHO B, et al. Clinical outcomes of stereotactic body radiation therapy for small hepatocellular carcinoma[J]. J Gastroenterol Hepatol, 2020, 35(11): 1953-1959. DOI: 10.1111/jgh.15011.
    [20]
    OHRI N, TOMÉ WA, MÉNDEZ ROMERO A, et al. Local control after stereotactic body radiation therapy for liver tumors[J]. Int J Radiat Oncol Biol Phys, 2018. DOI: 10.1016/j.ijrobp.2017.12.288.
    [21]
    GUHA C, KAVANAGH BD. Hepatic radiation toxicity: Avoidance and amelioration[J]. Semin Radiat Oncol, 2011, 21(4): 256-263. DOI: 10.1016/j.semradonc.2011.05.003.
    [22]
    JUNG J, YOON SM, KIM SY, et al. Radiation-induced liver disease after stereotactic body radiotherapy for small hepatocellular carcinoma: Clinical and dose-volumetric parameters[J]. Radiat Oncol, 2013, 8: 249. DOI: 10.1186/1748-717X-8-249.
    [23]
    SON SH, CHOI BO, RYU MR, et al. Stereotactic body radiotherapy for patients with unresectable primary hepatocellular carcinoma: Dose-volumetric parameters predicting the hepatic complication[J]. Int J Radiat Oncol Biol Phys, 2010, 78(4): 1073-1080. DOI: 10.1016/j.ijrobp.2009.09.009.
    [24]
    SU TS, LIANG P, LU HZ, et al. Stereotactic body radiation therapy for small primary or recurrent hepatocellular carcinoma in 132 Chinese patients[J]. J Surg Oncol, 2016, 113(2): 181-187. DOI: 10.1002/jso.24128.
    [25]
    MOORE A, COHEN-NAFTALY M, TOBAR A, et al. Stereotactic body radiation therapy (SBRT) for definitive treatment and as a bridge to liver transplantation in early stage inoperable hepatocellular carcinoma[J]. Radiat Oncol, 2017, 12(1): 163. DOI: 10.1186/s13014-017-0899-4.
    [26]
    KUBO K, KIMURA T, AIKATA H, et al. Long-term outcome of stereotactic body radiotherapy for patients with small hepatocellular carcinoma[J]. Hepatol Res, 2018, 48(9): 701-707. DOI: 10.1111/hepr.13063.
    [27]
    SU TS, LIANG P, LIANG J, et al. Long-term survival analysis of stereotactic ablative radiotherapy versus liver resection for small hepatocellular carcinoma[J]. Int J Radiat Oncol Biol Phys, 2017, 98(3): 639-646. DOI: 10.1016/j.ijrobp.2017.02.095.
    [28]
    SUN J, WANG Q, HONG ZX, et al. Stereotactic body radiotherapy versus hepatic resection for hepatocellular carcinoma (≤5 cm): A propensity score analysis[J]. Hepatol Int, 2020, 14(5): 788-797. DOI: 10.1007/s12072-020-10088-0.
    [29]
    SEO YS, KIM MS, YOO HJ, et al. Radiofrequency ablation versus stereotactic body radiotherapy for small hepatocellular carcinoma: A Markov model-based analysis[J]. Cancer Med, 2016, 5(11): 3094-3101. DOI: 10.1002/cam4.893.
    [30]
    WAHL DR, STENMARK MH, TAO Y, et al. Outcomes after stereotactic body radiotherapy or radiofrequency ablation for hepatocellular carcinoma[J]. J Clin Oncol, 2016, 34(5): 452-459. DOI: 10.1200/JCO.2015.61.4925.
    [31]
    KIM N, CHENG J, JUNG I, et al. Stereotactic body radiation therapy vs. radiofrequency ablation in Asian patients with hepatocellular carcinoma[J]. J Hepatol, 2020, 73(1): 121-129. DOI: 10.1016/j.jhep.2020.03.005.
    [32]
    PAN CC, KAVANAGH BD, DAWSON LA, et al. Radiation-associated liver injury[J]. Int J Radiat Oncol Biol Phys, 2010, 76(3 Suppl): s94-s100. DOI: 10.1016/j.ijrobp.2009.06.092.
    [33]
    BAUMANN BC, WEI J, PLASTARAS JP, et al. Stereotactic Body Radiation Therapy (SBRT) for hepatocellular carcinoma: High rates of local control with low toxicity[J]. Am J Clin Oncol, 2018, 41(11): 1118-1124. DOI: 10.1097/COC.0000000000000435.
    [34]
    KIM JW, SEONG J, LEE IJ, et al. Phase Ⅰ dose escalation study of helical intensity-modulated radiotherapy-based stereotactic body radiotherapy for hepatocellular carcinoma[J]. Oncotarget, 2016, 7(26): 40756-40766. DOI: 10.18632/oncotarget.9450.
    [35]
    DOBRZYCKA M, SPYCHALSKI P, ROSTKOWSKA O, et al. Stereotactic body radiation therapy for early-stage hepatocellular carcinoma - a systematic review on outcome[J]. Acta Oncol, 2019, 58(12): 1706-1713. DOI: 10.1080/0284186X.2019.1657942.
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