Among the 34 therapies with a complete radiological response, 14 therapies with a favorable α-fetoprotein decrease had a better disease-free survival curve than 20 therapies with an unfavorable α-fetoprotein decrease (P = 0.003). Only one case had a favorable α-fetoprotein decrease, but incomplete radiological response, with massive Epigenetics Compound Library necrosis, with the exception of a small residual tumor. Conclusions: A favorable α-fetoprotein decrease has better predictive power for disease-free survival than for an unfavorable α-fetoprotein decrease. HCC patients after RFA with an unfavorable α-fetoprotein decrease should be considered to have undergone incomplete treatment, despite the complete response by standard image modality
post-RFA. ”
“The aim of this study was to evaluate portal vein and bile duct toxicity after stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC). We retrospectively reviewed 63 patients who were administrated SBRT once for HCC. The prescribed doses were from 48 Gy in four fractions to 60 Gy in eight fractions. Portal vein thrombosis and bile duct stenosis were evaluated. AZD1208 chemical structure The dose received by 2% of the volume (D2) of the portal vein and bile duct was calculated. Portal vein thrombosis was observed in three patients (4.8%).
Common points of these patients were Child–Pugh class B and D2 of the portal vein 40 Gy or more (BED3 ≥200 Gy). Bile duct stenosis was observed in one patient (1.6%). The patient had a history of cholangiocarcinoma and left hepatic lobectomy. Portal vein thrombosis may be necessary to be considered when SBRT for HCC is administrated to patients in higher Child–Pugh class with higher D2 of the portal vein. THE CURATIVE THERAPY for hepatocellular carcinoma (HCC) is surgery. However, only 10–30% of patients with HCC are suitable for surgery. Ablation or transarterial chemoembolization (TACE) are recommended as alternative locoregional treatment. Radiation therapy Paclitaxel price is considered as an alternative to ablation or TACE.[1, 2] Owing to recent advances in radiation techniques,
stereotactic body radiation therapy (SBRT) enables accurate delivery of high radiation doses to a specific lesion. Preliminary data suggest that SBRT for HCC results in a good local control and rare treatment-related severe toxicity.[3-6] The major toxicity of SBRT for HCC is radiation-induced liver disease (RILD). Tolerance doses to the liver were analyzed in a review using historical RILD data.[7] In the review, portal vein or biliary duct damage were also suggested, but dose constraints were not mentioned because there are few data on toxicity of these structures.[8-11] In this report, we focus on adverse effects of portal vein and biliary duct system after SBRT for HCC, and document three cases of portal vein thrombosis and one case of bile duct stenosis, which contain dose–volume information of the portal vein and bile duct.