Effect of CyberKnife stereotactic body radiation therapy for hepatocellular carcinoma on hepatic toxicity
Authors Liang P, Huang C, Liang S, Li Y, Huang S, Lian Z, Liu J, Tang Y, Lu H
Received 8 May 2016
Accepted for publication 23 September 2016
Published 18 November 2016 Volume 2016:9 Pages 7169—7175
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Ru Chen
Peer reviewer comments 3
Editor who approved publication: Dr Yao Dai
Ping Liang,1,* Cheng Huang,2,* Shi-Xiong Liang,2,3 Ye-Fei Li,3 Shang-Xiao Huang,2 Zu-Ping Lian,1 Jian-Min Liu,1 Yang Tang,1 Hai-Jie Lu4
1Department of Radiation Oncology, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, 2Department of Radiation Oncology, Cancer Hospital, Guangxi Medical University, Nanning, 3Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 4Department of Radiation Oncology, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, People’s Republic of China
*These authors contributed equally to this work
Objective: To evaluate the safety of CyberKnife stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) patients and identify the treatment-related risk factors of hepatic toxicity.
Materials and methods: One hundred and four HCC patients treated with CyberKnife SBRT were included in this study between August 2009 and December 2012. The average dose of prescribed radiation was 42.81±4.78 Gy (28–55 Gy) with the average fraction size of 8–16 Gy to the planning target volume. The average fractions were 3.31±0.81 (2–6 fractions). Response rates were determined, and the Child–Pugh (CP) score and class following CyberKnife SBRT were obtained to evaluate hepatic toxicity.
Results: Seventeen patients experienced progression in CP class and 24 patients experienced CTCAE V. 4.0 grade 2–3 hepatic toxicity during the five-month follow-up period, while no patient experienced grade 4 liver toxicity. Multivariate analysis indicated that only V25 was an independent factor in grade 2–3 hepatic toxicity (P=0.029, <0.05). Radiation-induced hepatic toxicity (RIHT), defined as an increase of at least two points within three months following CyberKnife SBRT, occurred in 13 of the 104 patients (13/104, 12.5%), and only the normal liver tissue was found to be associated with RIHT (P=0.008, <0.05).
Conclusion: CyberKnife SBRT is a feasible and safe treatment for HCC with regard to hepatic toxicity, while V25 and normal liver volume may be an independent factor of grade 2–3 hepatic toxicity and RIHT, respectively.
Keywords: hepatocellular carcinoma, hepatic toxicity, CyberKnife stereotactic body radiation therapy (SBRT)
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]