Image-guided radiation therapy for liver tumors gastrointestinal histology matters Journal Article
| Authors: | Katsoulakis, E.; Riaz, N.; Cannon, D. M.; Goodman, K.; Spratt, D. E.; Lovelock, M.; Yamada, Y. |
| Article Title: | Image-guided radiation therapy for liver tumors gastrointestinal histology matters |
| Abstract: | Objectives: To describe the safety and efficacy of single-fraction and hypofractionated image-guided radiotherapy techniques for the treatment of large liver tumors. Methods: Forty-six patients, with 50 tumors (10 primary liver tumors, 40 liver metastases) from March 2004 to March 2011 were reviewed. The maximal tumor diameter ranged from 1.2 to 11.3 cm (median, 4.2 cm). Eighty-seven percent of patients received prior systemic chemotherapy. Fifty-nine percent had prior invasive local therapy including surgery, ablation, or embolization. Twenty-five lesions were treated with hypofractionated therapy (24 to 30 Gy in 3 to 5 fractions), whereas 19 received a single fraction (18 or 24 Gy). Local control (LC) was calculated using competing risk analysis. Overall survival was calculated by the Kaplan-Meier method. Results: Median follow-up for all patients was 29.8 months (range, 3 to 46 mo). The median survival was 15.4 months. The 1- and 2-year LC rates were 78% and 75%, respectively. Dose and tumor size had no significant effect on tumor progression. The local progression at 1 and 2 years was 29% and 32% for gastrointestinal (GI) histologies versus 0% for non-GI histologies (P = 0.02). Tumor volumes larger than 112 cm3 correlated with decreased survival (P = 0.05). Three patients developed late grade 3 GI stricture or ulceration. Conclusions: Image-guided radiotherapy for liver tumors achieves good rates of LC with minimal toxicity at 1 and 2 years even in patients with large or recurrent disease that has been heavily pretreated. GI histology demonstrated decreased LC rates. Further management strategies should be considered in these patients. |
| Keywords: | adult; cancer survival; clinical article; treatment outcome; middle aged; primary tumor; survival rate; overall survival; disease course; fatigue; diarrhea; cancer radiotherapy; follow up; esophagitis; nausea; radiation injury; abdominal pain; survival time; liver metastasis; radiation dose fractionation; liver tumor; cancer size; clinical effectiveness; radiation safety; portal vein thrombosis; dyspepsia; radiation necrosis; radiation dermatitis; duodenum ulcer; stomach obstruction; liver metastases; image-guided radiation therapy; primary liver tumors; stereotactic radiotherapy; gastritis; image guided radiotherapy; gastrointestinal tumors; epigastric discomfort; esophagus varices bleeding; esophagus stenosis; human; male; female; article |
| Journal Title: | American Journal of Clinical Oncology |
| Volume: | 37 |
| Issue: | 6 |
| ISSN: | 0277-3732 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2014-12-01 |
| Start Page: | 561 |
| End Page: | 567 |
| Language: | English |
| DOI: | 10.1097/COC.0b013e318282a86b |
| PROVIDER: | scopus |
| PUBMED: | 23466584 |
| DOI/URL: | |
| Notes: | Export Date: 2 January 2015 -- Source: Scopus |
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