Importance: Previous studies showed that 42% to 50% of patients with locally advanced hepatocellular carcinoma (HCC) achieved complete remission (CR) after combined locoregional therapy (LRT) plus immunotherapy (IO). However, data on predictors of CR and long-term clinical outcomes without surgery and after discontinuation of IO are lacking.
Objective: To assess the long-term clinical outcomes among patients with unresectable HCC who achieved CR after LRT-IO and were placed on a watch-and-wait protocol.
Purpose: Venezia™ is an interstitial brachytherapy applicator for treating advanced cervical and vaginal vault recurrent cancer. However, there are limitations that lead to suboptimal target coverage. 3D printing introduction allows the redesign of Venezia™ for bulky and irregular-shaped tumors.
View Article and Find Full Text PDFLancet Gastroenterol Hepatol
February 2023
Background: The synergy between locoregional therapies and immune checkpoint inhibitors has not been investigated as conversion therapy for unresectable hepatocellular carcinoma. We aimed to investigate the activity of sequential transarterial chemoembolisation (TACE) and stereotactic body radiotherapy followed by avelumab (an anti-PD-L1 drug) for locally advanced, unresectable hepatocellular carcinoma.
Methods: START-FIT was a single-arm, phase 2 trial in patients with locally advanced hepatocellular carcinoma who were not suitable for curative treatment, conducted in two hospitals in Hong Kong and one in Shenzhen, China.
Radiotherapy with electrons is commonly applied to the tumor bed after whole-breast radiotherapy following breast conservation surgery for breast cancer patients. However, the radiation dose to adjacent organs-at-risk (OARs) and conformity of planning target volume (PTV) cannot be optimized. In this study, we examine the feasibility of using modulated electron bolus (MEB) to improve PTV conformity and reduce the dose to these OARs.
View Article and Find Full Text PDFThis study aims at evaluating the symptom response, response duration, and toxicity of single dose palliative liver radiotherapy (RT) for symptomatic HCC patients. We reviewed unresectable HCC patients treated with palliative RT in our institution. Eligible patients were unsuitable or refractory to trans-arterial chemoembolization (TACE) and stereotactic body radiotherapy (SBRT), with an index symptom of pain or abdominal discomfort.
View Article and Find Full Text PDFIn radiosurgery (SRS), the geometric uncertainties of machine-related delivery including image-guidance and hence the planning target volume (PTV) are often evaluated by the end-to-end gamma (γ) comparison that carries no information about the clinical relevance of deviations of individual SRS plans during delivery quality assurance (DQA). A proof-of-concept method was proposed to derive the PTV against both the plan- and the machine-specific delivery errors directly from the clinically relevant dose-volume histograms (DVHs) using measured-guided dose reconstruction (MGDR) during DQA. A liquid-filled detector array and a rotating phantom were used to measure sixteen arc-based radiosurgery treatments with 1 and 2 mm gross tumor volume (GTV)-to-PTV margins, producing MGDR-3D dose distribution on both the phantom and the patient CT for γ index and clinical DVH evaluations, respectively.
View Article and Find Full Text PDFPurpose: We retrospectively evaluated the efficacy and safety of stereotactic body radiotherapy (SBRT) combined with trans-arterial chemoembolization (TACE) as initial therapy in Barcelona Clinic Liver Cancer (BCLC) system stage B-C hepatocellular carcinoma (HCC).
Patients And Methods: Seventy-two patients received a single dose of TACE followed by SBRT 4 weeks later. All patients had tumor sizes ≥5 cm, at least 700 ml of disease-free liver, Child-Pugh (CP) score ≤ B7 and tumor nodules ≤5.
Purpose: Computed tomography (CT) is inferior to magnetic resonance imaging (MRI) in cervical tumor delineation, but similar in identification of organs at risk (OAR). The trend to over-estimate high-risk and low-risk clinical target volume (HRCTV, IRCTV) on CT can lead to under-estimation of dose received by 90% (D) of the 'actual' CTV. This study aims to evaluate whether CT-guided planning delivers adequate dose to the 'actual' targets while spares the OAR similarly.
View Article and Find Full Text PDFAim: To investigate the dosimetric impacts of lung tumor motion in robotic hypofractionated radiotherapy for lung cancers delivered through continuous tracking of the vertebrae by the XSight Spine Tracking (XST) mode of the CyberKnife.
Materials And Methods: Four-dimensional computed tomography (4DCT) scans of a dynamic thorax phantom were acquired. Three motion patterns (one-dimensional and three-dimensional) of different range were investigated.