| Zhao Xianzhi,Zhang Huojun,Wang Xiaoyan,Dai Zhitao,Zhu Xiaofei,Qing Shuiwang,Ju Xiaoping,Liu Yongming.An initial report of CyberKnife stereotactic body radiotherapy in treatment of small hepatocellular carcinoma:a pilot study[J].Chinese Journal of Radiological Medicine and Protection,2017,37(11):843-849 |
| An initial report of CyberKnife stereotactic body radiotherapy in treatment of small hepatocellular carcinoma:a pilot study |
| Received:June 09, 2017 Revised:May 09, 2017 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.11.008 |
| KeyWords:Small hepatocellular carcinoma CyberKnife Stereotactic body radiotherapy Efficacy Adverse reactions |
| FundProject: |
| Author Name | Affiliation | E-mail | | Zhao Xianzhi | Department of Radiation Oncology, Shanghai Changhai Hospital, Shanghai 200433, China | | | Zhang Huojun | Department of Radiation Oncology, Shanghai Changhai Hospital, Shanghai 200433, China | chyyzhj@163.com | | Wang Xiaoyan | Department of Radiation Oncology, Shanghai Changhai Hospital, Shanghai 200433, China | | | Dai Zhitao | Department of Radiation Oncology, Shanghai Changhai Hospital, Shanghai 200433, China | | | Zhu Xiaofei | Department of Radiation Oncology, Shanghai Changhai Hospital, Shanghai 200433, China | | | Qing Shuiwang | Department of Radiation Oncology, Shanghai Changhai Hospital, Shanghai 200433, China | | | Ju Xiaoping | Department of Radiation Oncology, Shanghai Changhai Hospital, Shanghai 200433, China | | | Liu Yongming | Department of Radiation Oncology, Shanghai Changhai Hospital, Shanghai 200433, China | |
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| Abstract:: |
| Objective To determine the effectiveness and safety of patients treated with stereotactic body radiotherapy (SBRT)-CyberKnife for small hepatocellular carcinoma. Methods A prospective analysis of treatment details and outcomes for 33 patients with small hepatocellular carcinoma treated by CyberKnife at CyberKnife center of Shanghai Changhai Hospital from June 2014 to December 2016 was presented. Patients were followed every 3 months. WHO modified response evaluation criteria in solid Tumors(mRECIST)was used to evaluate efficacy, Common Terminology Criteria for Adverse Events Version 4.0(CTCAE 4.0) to evaluate treatment response, Kaplan-Meier method to calculate survival rate and local control rate and plot survival curves. Results There were 33 patients, 33 targets included in the study at the date of the last follow-up. 18 lesions (54.5%) showed complete remission response, 7 lesions (21.2%) showed partial remission response, 5 lesions (15.2%) showed stable, and 3 lesions (9.1%) progressed. Response rate was 75.8%, and disease control rate was 90.9%. 1-and 2-year local control rate was 100% and 83.6%, respectively. The median disease progression free survival (DPFS) was 15.0 months. Non irradiated liver volume more than 100 ml, prior AFP less than 100 ng/ml, post-treatment CTCAE less than grade 2 could improve overall survival(OS). V5 was a factor in grades 2-4 hepatic toxicity (P=0.015). All patients tolerated the radiosurgery, with grade 1 and grade 2 fatigue, and the gastrointestinal reactions and liver injury was the main side effect. 1 patient with grade 3 liver damage relieved at 6 months after treatment and 1 patient with grade 4 liver damage cured at 12 months after treatment. No grade 5 toxicity was encountered. Conclusions CyberKnife seems to be a safe and effective treatment measure with tolerated adverse reaction and good local control rate for patients with small hepatocellular carcinoma. |
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