Objective: To evaluate the role of palliative stereotactic body radiation therapy (SBRT) in Barcelona Clinic Liver Cancer stage‑C (BCLC-C) hepatocellular carcinoma (HCC) patients who are not suitable for other loco-regional therapies.
Materials And Methods: It is an observational retrospective study done between May 2020 and September 2021. The data were collected from 35 patients of advanced HCC who underwent SBRT. Patients of Child Pugh status (CPs) A5-B7 and with a liver reserve of ≥ 700cc were included. Local control (LC), overall survival (OS) and adverse events including decompensation were carefully recorded.
Results: In the cohort, Portal vein and IVC tumor thrombosis were present in 33 (94.3%) and 8 (22.85%) patients, respectively. Lung and nodal metastasis were found in 11 (31.4%) and 21 (60%) of patients, respectively. The median gross tumor volume (GTV) was 563cc (range 80-1925cc). The median SBRT dose prescription was 35 Gy (range 25-40 Gy) in 5-10 fractions. Post radiation therapy, there was improvement in pain and discomfort in 24 out of 29 (82.75%) and 18 out of 23 (78%) patients respectively. Also bone metastasis related pain was improved in all 3 (100%) patients. One year LC, and OS were 80% and 30% respectively. On multivariate analysis, the GTV volume > 750cc and PIVKA-II > 8000 mAU/ml remained the predictor factor for poor OS. Post SBRT, change in child-pugh score by 1 point was observed in 7 patients (20%) which was managed conservatively.
Conclusion: SBRT is a safe and feasible option for BCLC‑C HCC. It not only improves the quality of life by symptom control but also results in good LC and OS with acceptable toxicity. SBRT should be considered in a multidisciplinary fashion for patients presenting with advanced HCCs.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00066-023-02065-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Influence of Anesthesia on Neuromonitoring During Scoliosis Surgery: A Systematic Review.
NeuroSci
December 2024
Department of Palliative Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland.
Background: Intraoperative neuromonitoring (IONM) is crucial for the safety of scoliosis surgery, providing real-time feedback on the spinal cord and nerve function, primarily through motor-evoked potentials (MEPs). The choice of anesthesia plays a crucial role in influencing the quality and reliability of these neuromonitoring signals. This systematic review evaluates how different anesthetic techniques-total intravenous anesthesia (TIVA), volatile anesthetics, and regional anesthesia approaches such as Erector Spinae Plane Block (ESPB), spinal, and epidural anesthesia-affect IONM during scoliosis surgery.
View Article and Find Full Text PDFFeatures of the Nurse-Patient Relationship: Insights from a Qualitative Review Using Artificial Intelligence Interpretation.
Curr Oncol
December 2024
Advanced Data Analysis in Medicine (ADAM), Laboratory of Interdisciplinary Research Applied to Medicine (DReAM), University of Salento and ASL (Local Health Authority), 73100 Lecce, Italy.
Introduction: This qualitative literature review explored the intersection of art, creativity, and the nurse-patient relationship in the context of oncology nursing. It delved into the perceptions and reflections of nurses as captured by Generative Artificial Intelligence (GAI) analysis from two specialized nursing databases.
Methods: The protocol was registered on the Open Science Framework (OSF) Platform.
Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches-A Systematic Review with an Institutional Case Illustration.
Curr Oncol
November 2024
Department of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy.
(1) Background: Testicular cancer, although accounting for only 0.5% to 1% of all solid male cancers, is the most common malignancy in males aged 15 to 35 years. Non-seminomatous germ cell tumors (NSGCT) represent nearly half of all testicular germ cell tumors and are associated with a more aggressive clinical course.
View Article and Find Full Text PDFHigh Fracture Risk of Femoral Bone Metastasis Treated with Palliative Radiotherapy in Recent Years.
Curr Oncol
November 2024
Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan.
Bone-modifying agents (BMAs) have been widely used to reduce skeletal-related events, including pathological fractures. Herein, we aimed to clarify the incidence of pathological fractures caused by high-risk femoral bone metastases after palliative radiotherapy (RT) in the BMA era and evaluate the necessity of prophylactic surgical stabilization. We assessed 90 patients with high-risk femoral bone metastases, indicated by Mirels' scores ≥ 8, without pathological fractures and surgical fixations, who received palliative RT at our institution between January 2009 and December 2018.
View Article and Find Full Text PDFThe effects of psychosocial aftercare following pediatric chronic pain treatment withstand the coronavirus disease 2019 pandemic: long-term outcomes of a randomized controlled trial.
Pain Rep
February 2025
German Paediatric Pain Centre, Children's and Adolescents' Hospital Datteln, Datteln, Germany.
Introduction: Intensive interdisciplinary pain treatment (IIPT) is the best therapy available for children and adolescents affected by severe chronic pain. Psychosocial aftercare (PAC) offered for 6 months after IIPT can improve treatment outcomes for up to 12 months.
Objectives: The current study is the first to explore whether PAC is superior to treatment as usual at a long-term follow-up of 18 to 33 months after discharge-including when facing the coronavirus disease 2019 (COVID-19) pandemic.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!