Relationship Between Dose and Local Control in Five-fraction Stereotactic Body Radiotherapy for Hepatocellular Carcinoma.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

In vivo Pub Date : 2025-09-01 DOI:10.21873/invivo.14090

Yuta Nishikawa, Ichiro Ogino, Yuki Mukai, Akihiro Funaoka, Yuriko Takeda, Masaharu Hata

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Abstract

Background/aim: To retrospectively analyze the relationship between local control (LC) and the minimum dose covering 95% of the planning target volume (PTV D95%) in patients with hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT).

Patients and methods: Between May 2020 and March 2024, 72 HCC tumors in 59 patients were evaluated at Yokohama City University Medical Center. The prescribed dose ranged from 30-50 Gy in five fractions in accordance with the RTOG 1112 trial. However, PTV D95% was used for evaluation because of dose reductions near organs at risk.

Results: The median follow-up period was 20 months. During this period, 13 patients died, and nine local recurrences were observed. The median PTV D95% was 38.9 Gy (range=10.6-48.5 Gy). The 1- and 2-year LC rates were 93.7% and 82.3%, respectively. Both univariate and multivariate analyses identified PTV D95% as a significant prognostic factor for LC [univariate: hazard ratio (HR)=0.882, 95% confidence interval (CI)=0.797-0.977, p=0.016; multivariate: HR=0.891, 95%CI=0.891-0.989, p=0.031]. Notably, no local recurrences were observed in patients with PTV D95% ≥40 Gy. Receiver operating characteristic analysis determined that 38 Gy was the optimal PTV D95% cut-off to prevent local recurrence, based on Youden's index.

Conclusion: PTV D95% was a significant prognostic factor for LC in patients with HCC treated with five-fraction SBRT. These findings suggest that PTV D95% ≥40 Gy should be considered as a cut-off dose to prevent recurrence.

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肝细胞癌立体定向放射治疗中剂量与局部控制的关系。

背景/目的：回顾性分析肝细胞癌（HCC）立体定向放射治疗（SBRT）患者局部控制（LC）与覆盖计划靶体积95%的最小剂量（PTV D95%）的关系。患者和方法：2020年5月至2024年3月，横滨市立大学医学中心对59例患者的72例HCC肿瘤进行了评估。根据RTOG 1112试验，处方剂量范围为30-50 Gy，分为五个部分。然而，由于危险器官附近的剂量减少，使用PTV D95%进行评估。结果：中位随访时间为20个月。在此期间，13例患者死亡，9例局部复发。中位PTV D95%为38.9 Gy（范围10.6-48.5 Gy）。1年期和2年期贷款利率分别为93.7%和82.3%。单因素和多因素分析均发现PTV D95%是LC的重要预后因素[单因素：风险比(HR)=0.882, 95%可信区间(CI)=0.797-0.977, p=0.016；多因素分析：HR=0.891, 95%CI=0.891 ~ 0.989, p=0.031。值得注意的是，D95%≥40 Gy的PTV患者没有局部复发。根据约登指数（Youden's index），受试者工作特征分析确定38 Gy为预防局部复发的最佳PTV D95%截止值。结论：PTV D95%是五段式SBRT治疗HCC患者LC的重要预后因素。这些发现提示PTV D95%≥40 Gy应被视为预防复发的截止剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.