Analysis of the factors affecting the safety of robotic stereotactic body radiation therapy for hepatocellular carcinoma patients

作者：Liu, Xiaojie; Song, Yongchun; Liang, Ping; Su, Tingshi; Zhang, Huojun; Zhao, Xianzhi; Yuan, Zhiyong; Wang, Ping^*

来源：OncoTargets and Therapy, 2017, 10: 5289-5295.

DOI：10.2147/OTT.S142025

• hepatocellular carcinoma
• robotic stereotactic body radiation therapy
• CyberKnife
• Child-Turcotte-Pugh class
• adverse hepatic reactions

Objective: The objective of this study was to investigate the safety of robotic stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) patients and its related factors.
Methods: A total of 74 HCC patients with Child-Turcotte-Pugh (CTP) Class A were included in a multi-institutional, single-arm Phase II trial (NCT 02363218) between February 2013 and August 2016. All patients received SBRT treatment at a dose of 45 Gy/3f. The liver function was compared before and after SBRT treatment by the analysis of adverse hepatic reactions and changes in CTP classification.
Results: After SBRT treatment, eight patients presented with decreases in CTP classification and 13 patients presented with >= grade 2 hepatic adverse reactions. For patients presenting with >= grade 2 hepatic adverse reactions, the total liver volume of <= 1,162 mL and a normal liver volume (total liver volume-gross tumor volume [GTV]) of <= 1,148 mL were found to be independent risk factors and statistically significant (P<0.05).
Conclusion: The total liver volume and normal liver volume are associated with the occurrence of >= grade 2 hepatic adverse reactions after SBRT treatment on HCC patients. Therefore, if the fractionated scheme of 45 Gy/3f is applied in SBRT for HCC patients, a total liver volume >1,162 mL and a normal liver volume >1,148 mL should be ensured to improve therapeutic safety.

• 出版日期2017
• 单位广西中医药大学; 中国人民解放军第二军医大学; 天津医科大学