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dc.contributor.authorLee, Peter L.
dc.contributor.authorMa, Yunsheng
dc.contributor.authorZacharias, Isabel
dc.contributor.authorBozorgzadeh, Adel
dc.contributor.authorWilson, Sean
dc.contributor.authorFoley, Kim
dc.contributor.authorRava, Paul
dc.contributor.authorMasciocchi, Mark
dc.contributor.authorDing, Linda
dc.contributor.authorBledsoe, Jacob R.
dc.contributor.authorFitzgerald, Thomas J.
dc.contributor.authorSioshansi, Shirin
dc.date2022-08-11T08:10:49.000
dc.date.accessioned2022-08-23T17:21:10Z
dc.date.available2022-08-23T17:21:10Z
dc.date.issued2020-04-09
dc.date.submitted2020-12-14
dc.identifier.citation<p>Lee P, Ma Y, Zacharias I, Bozorgzadeh A, Wilson S, Foley K, Rava P, Masciocchi M, Ding L, Bledsoe J, Fitzgerald TJ, Sioshansi S. Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma in Patients With Child-Pugh B or C Cirrhosis. Adv Radiat Oncol. 2020 Apr 9;5(5):889-896. doi: 10.1016/j.adro.2020.01.009. PMID: 33083650; PMCID: PMC7557134. <a href="https://doi.org/10.1016/j.adro.2020.01.009">Link to article on publisher's site</a></p>
dc.identifier.issn2452-1094 (Linking)
dc.identifier.doi10.1016/j.adro.2020.01.009
dc.identifier.pmid33083650
dc.identifier.urihttp://hdl.handle.net/20.500.14038/48462
dc.description.abstractPurpose: Our purpose was to report outcomes in patients with Child-Pugh B or C (CP B/C) hepatocellular carcinoma (HCC) treated with stereotactic body radiation therapy (SBRT). Methods and Materials: Patients with HCC suitable for SBRT were prospectively enrolled in the study from 2012 to 2018. Outcomes in patients with CP B/C were analyzed. Cox proportional hazard models were used to compare survival outcomes between baseline CP score and post-SBRT CP score. Results: Twenty-three patients with CP B/C with a total of 29 HCC tumors were treated with SBRT. Eighty-seven percent of patients were CP B8-C10. Median tumor size was 3.1 cm (range, 1-10 cm). Median dose delivered was 40 Gy in a median of 5 fractions. Eighteen of 23 patients (78.3%) had been previously treated with transarterial chemoembolization. Median follow-up was 14.5 months. Rates of 6- and 12-month local control were 100% and 92.3%, respectively. Six- and 12-month survival rates were 73.9% and 56.5%, respectively. Median survival was 14.5 months overall and 9.2, 22.5, 14.5, and 14.4 months for patients with CP B7, B8, B9, and C10, respectively. No patients exhibited symptoms of classic radiation-induced liver disease. However, 10 patients had CP score progression, with 4 patients (17%) having a > /=2-point increase in CP score by 6 months (or time of censor). There were 7 liver-related deaths, and based on independent review by a hepatologist, 1 of these deaths may have been attributable to SBRT-related liver injury. Fifteen of 23 patients were listed for liver transplant (LT) at the time of SBRT and 9 went on to receive LT with a pathologic complete response rate of 63.6%. Median survival, excluding patients who received LT, was 7.3 months. Conclusions: SBRT is a reasonable treatment option for carefully selected patients with CP B7-C10. In our small cohort, there was no detectable difference between local control or overall survival and baseline CP score.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=33083650&dopt=Abstract">Link to Article in PubMed</a></p>
dc.rightsCopyright 2020 The Author(s). Published by Elsevier Inc. on behalf of American Society for Radiation Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjecthepatocellular carcinoma
dc.subjectstereotactic body radiation therapy
dc.subjectchild-pugh
dc.subjectcirrhosis
dc.subjectDigestive System Diseases
dc.subjectNeoplasms
dc.subjectOncology
dc.subjectPathological Conditions, Signs and Symptoms
dc.subjectRadiation Medicine
dc.subjectRadiology
dc.titleStereotactic Body Radiation Therapy for Hepatocellular Carcinoma in Patients With Child-Pugh B or C Cirrhosis
dc.typeJournal Article
dc.source.journaltitleAdvances in radiation oncology
dc.source.volume5
dc.source.issue5
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1579&amp;context=radiology_pubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/radiology_pubs/567
dc.identifier.contextkey20590153
refterms.dateFOA2022-08-23T17:21:10Z
html.description.abstract<p>Purpose: Our purpose was to report outcomes in patients with Child-Pugh B or C (CP B/C) hepatocellular carcinoma (HCC) treated with stereotactic body radiation therapy (SBRT).</p> <p>Methods and Materials: Patients with HCC suitable for SBRT were prospectively enrolled in the study from 2012 to 2018. Outcomes in patients with CP B/C were analyzed. Cox proportional hazard models were used to compare survival outcomes between baseline CP score and post-SBRT CP score.</p> <p>Results: Twenty-three patients with CP B/C with a total of 29 HCC tumors were treated with SBRT. Eighty-seven percent of patients were CP B8-C10. Median tumor size was 3.1 cm (range, 1-10 cm). Median dose delivered was 40 Gy in a median of 5 fractions. Eighteen of 23 patients (78.3%) had been previously treated with transarterial chemoembolization. Median follow-up was 14.5 months. Rates of 6- and 12-month local control were 100% and 92.3%, respectively. Six- and 12-month survival rates were 73.9% and 56.5%, respectively. Median survival was 14.5 months overall and 9.2, 22.5, 14.5, and 14.4 months for patients with CP B7, B8, B9, and C10, respectively. No patients exhibited symptoms of classic radiation-induced liver disease. However, 10 patients had CP score progression, with 4 patients (17%) having a > /=2-point increase in CP score by 6 months (or time of censor). There were 7 liver-related deaths, and based on independent review by a hepatologist, 1 of these deaths may have been attributable to SBRT-related liver injury. Fifteen of 23 patients were listed for liver transplant (LT) at the time of SBRT and 9 went on to receive LT with a pathologic complete response rate of 63.6%. Median survival, excluding patients who received LT, was 7.3 months.</p> <p>Conclusions: SBRT is a reasonable treatment option for carefully selected patients with CP B7-C10. In our small cohort, there was no detectable difference between local control or overall survival and baseline CP score.</p>
dc.identifier.submissionpathradiology_pubs/567
dc.contributor.departmentDepartment of Pathology
dc.contributor.departmentDepartment of Radiation Oncology
dc.contributor.departmentDepartment of Radiology
dc.contributor.departmentDepartment of Surgery
dc.source.pages889-896


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Copyright 2020 The Author(s). Published by Elsevier Inc. on behalf of American Society for Radiation Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Except where otherwise noted, this item's license is described as Copyright 2020 The Author(s). Published by Elsevier Inc. on behalf of American Society for Radiation Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).