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• W4236085865 abstract "To investigate the side-effects, toxicities, and efficacy of hypofractionated 3DCRT for PLC. From April 1999 to August 2003, 128 patients with PLC received hypofractionated 3DCRT at cancer hospital, Guangxi Medical University. All patients were technical unresectable or medical inoperable due to poor liver function or cardiovascular diseases. The clinical characteristics of these patients were as follows: 113 male, 15 female; median age of 48.2 (27–72); with portal vein thrombosis (PVT) in 34 cases, and without it in 94 cases; hepatitis B virus (HBV) positive in 93 cases, negative in 35 cases; liver cirrhosis of Child-Pugh grade A in 108 cases, Child-Pugh grade B in 20 cases. 3DCRT was carried out by 8MV x-ray with Topslane treatment planning system. Multiple coplanar or non-coplanar fields were used to implement hypofractionated 3DCRT. In 48 patients transarterial chemoembolization (TACE) was performed prior to 3DCRT with DDP,ADM and MMC. 3DCRT was delivered by 4.88 ± 0.47Gy(4-8Gy)/fraction, three fractions per week (Mon., Wed. and Fri.) with a median total dose of 53.6Gy ± 6.6Gy. The mean value of gross target volume (GTV) was 458.92 ± 429.8cm3. The mean follow-up time was 14.2(1–53)months. The most severe complication was radiation-induced liver disease (RILD), which occurred in 19 cases (15%) with 16 deaths due to RILD (detailed analysis of RILD had been present in another paper). The other side-effects included ulcerations in stomach as well as nausea, vomiting and fatigue, but not severe. As to immediate responses, 7 cases died within 3 months after treatment, were not evaluated. The response rate (CR+PR) was 55% (67/121). Stable disease was observed in 17 cases (14%), and progressive disease, in 37 patients (31%), which included 34 cases of intrahepatic metastasis and 3 cases of local progression. The median survival time was 14.2 months for entire group. The overall survival rates at 1, 2, and 3 years were 65%, 43% and 33%, respectively. Prognostic factors evaluated included gender, age, GTV, alpha-fetoprotein (AFP) level, infection of hepatitis B virus (HBV), PVT, use of TACE, Child-Pugh grade of liver cirrhosis. Univariate analyses demonstrated that GTV, PVT and liver cirrhosis of Child-Pugh grade had significant impact on the overall survival (p = 0.0000, 0.0001and 0.0000, respectively). Large GTV, exist of PVT and Child-Pugh B were the unfavorable factors for prognosis. By Cox-regression analysis, GTV and Child-Pugh grade of liver cirrhosis had significant impact on survival (p = 0.04 and 0.03). Hypofractionated 3DCRT could be tolerated by PLC patients with liver cirrhosis of Child-Pugh A, but not with Child-Pugh B.Hypofractionated 3DCRT had achieved substantial tumor regression and survival. GTV and status of live cirrhosis had significant impact on the overall survival in favor of small GTV and patients with liver cirrhosis of Child-Pugh A" @default.
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• W4236085865 date "2004-09-01" @default.
• W4236085865 modified "2023-09-27" @default.
• W4236085865 title "Hypofractionated three-dimensional conformal radiation therapy (3DCRT) for primary liver carcinoma (PLC)" @default.
• W4236085865 doi "https://doi.org/10.1016/s0360-3016(04)01622-0" @default.
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