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• W2896933544 abstract "Recent advances in radiotherapy (RT) technologies, such as intensity-modulated radiotherapy (IMRT), have enabled the delivery of tumoricidal doses to intrahepatic malignancies while protecting the normal organs. This study evaluated the effects of high-dose RT among patients with locally advanced Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma (BCLC-C HCC). This study retrospectively evaluated data from 637 patients who received RT with concurrent hepatic arterial floxuridine for BCLC-C HCC without distant metastases during 2005–2016. These cases included 514 patients (81%) who were treatment-naïve. Receiver operating characteristic curve analysis showed that the optimal cut-off for the biologically effective dose (BED) was 72 Gy, and the patients were divided into ≥72 Gy (n=101) and BED <72 Gy (n=536). In the BED ≥72 Gy and <72 Gy groups, 94 of 101 patients (93%) and 128 of 536 patients (24%) used IMRT, respectively. The median overall survival (OS) was 16.3 months, with a median follow-up of 12.4 months (19.8 months among patients who were alive). The BED ≥72 Gy and <72 Gy groups had median OSs of 39.7 months and 14.5 months, and 1-year OS rates of 73% and 58%, respectively (P <.001). The 1-year local control (LC) rate was significantly higher in the high-dose group (95% vs. 78%; P <.001). After propensity score matching, 83 matched pairs were created, and the high-dose group still had significantly better 1-year LC rate (95% vs. 82%; P =.006) and 1-year OS rate (71% vs. 62%; P =.01). In the multivariate model, the BED ≥72 Gy was an independent predictor of LC (hazard ratio [HR], 0.26; 95% confidence interval [CI], 0.11–0.61; P =.002) and OS (HR 0.50; 95% CI, 0.33–0.77, P =.002). The surgical conversion rate was significantly higher in the high-dose group (20% vs. 12%, P =.03), with markedly increased median OS among patients who underwent surgery (103.8 months vs. 13.1 months; P <.001). There were no significant differences in gastrointestinal bleeding or radiation-induced liver disease. High-dose RT, which was enabled by IMRT increased LC and OS after liver-directed chemoradiotherapy for locally advanced BCLC-C HCC. It also increased the surgical conversion rate, which contributed to the improved OS." @default.
• W2896933544 created "2018-10-26" @default.
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• W2896933544 date "2018-11-01" @default.
• W2896933544 modified "2023-09-26" @default.
• W2896933544 title "High-Dose Radiation in Liver-Directed Concurrent Chemoradiotherapy Is Effective for Locally Advanced BCLC Stage C Hepatocellular Carcinoma" @default.
• W2896933544 doi "https://doi.org/10.1016/j.ijrobp.2018.07.467" @default.
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