ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2019
A mid-treatment break and reassessment maintains tumor control and reduces toxicity in patients with hepatocellular carcinoma treated with stereotactic body radiation therapy.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 60 citations in OpenAlex.
- A Phase II Study of Optimized Individualized Adaptive Radiotherapy for Hepatocellular Carcinoma.Clinical cancer research : an official journal of the American Association for Cancer Research · 2023Trial
- α/β for Hepatocellular Carcinoma Tumors Treated With Radiation Therapy.International journal of radiation oncology, biology, physics · 2026Article
- Assessing the Relationship Between MR-Based Functional Dose Metrics and Post-Stereotactic Body Radiation Therapy Albumin-Bilirubin Change.International journal of radiation oncology, biology, physics · 2025Article
- Intricacies of human-AI interaction in dynamic decision-making for precision oncology.Nature communications · 2025Article
- Risk Factors of Non-Classic Radiation-Induced Liver Disease (ncRILD) After Intensity-Modulated Radiotherapy in Hepatocellular Carcinoma.Cancer management and research · 2025Article
- The Use of Magnetic Resonance Imaging in Radiation Therapy Treatment Simulation and Planning.Journal of magnetic resonance imaging : JMRI · 2024Review
- Radiation dose is associated with improved local control for large, but not small, hepatocellular carcinomas.Radiation oncology (London, England) · 2023Article
- A clinical decision support system for AI-assisted decision-making in response-adaptive radiotherapy (ARCliDS).Scientific reports · 2023Article
- The Effect of Stereotactic Body Radiation Therapy for Hepatocellular Cancer on Regional Hepatic Liver Function.International journal of radiation oncology, biology, physics · 2023Article
- LI-RADS Treatment Response Algorithm: Performance and Diagnostic Accuracy With Radiologic-Pathologic Explant Correlation in Patients With SBRT-Treated Hepatocellular Carcinoma.International journal of radiation oncology, biology, physics · 2022Article
- A human-in-the-loop based Bayesian network approach to improve imbalanced radiation outcomes prediction for hepatocellular cancer patients with stereotactic body radiotherapy.Frontiers in oncology · 2022Article
- Evolution of Response-Based Radiotherapy for Hepatocellular Cancer.Cancer journal (Sudbury, Mass.)Review
- Is Apparent Diffusion Coefficient Established as an Imaging Biomarker for Stereotactic Body Radiation Therapy Assessment in Hepatocellular Carcinoma?Cancer journal (Sudbury, Mass.)Review
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9 authors at 2 institutions in 1 country.
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Abstract
background and purposePatients with hepatocellular carcinoma (HCC) commonly have underlying liver dysfunction with variable tolerance to liver stereotactic body radiation therapy (SBRT). We hypothesized that insertion of a 1-month mid-treatment break would allow us to adapt treatment to the individual patient response, thereby reducing toxicity without compromising local control (LC). MATERIALS AND
methodsWe analyzed HCC patients receiving 3-5 fraction SBRT at our institution from 2005 to 2017. Over this time, patients were offered enrollment on prospective trials assessing individualized adaptive SBRT. Based on normal tissue complication probability and modeling of changes in liver function following a 1-month treatment break between fractions 3 and 4, patients could receive a total of 3 or 5 fractions. Patients not on trial received 3 or 5 fractions without a break. Toxicity was defined as a ≥2 point rise in Child-Pugh (CP) score within 6 months of SBRT.
results178 patients were treated with SBRT to 263 HCCs. Median follow-up was 23 months. 86 treatments had a 1-month break. 1-Year LC was 95.4%; this was not different between patients treated with or without a break (p = 0.14). Controlling for tumor size and dose a break was not associated with inferior LC (HR: 0.58, 95%CI: 0.1-3.34, p = 0.54). 54 patients experienced a ≥2 point rise in CP score. Controlling for the number of prior liver directed therapies and mean liver dose, a treatment break reduced the odds of toxicity (OR: 0.42, 95% CI: 0.17-1.03, p = 0.06).
conclusionA one-month mid-treatment break and reassessment may reduce the odds of treatment related toxicity without compromising LC.
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