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CC BY-NC-ND 4.0 · South Asian J Cancer 2018; 07(03): 175-182
DOI: 10.4103/sajc.sajc_19_18
ORIGINAL ARTICLE: Gastro-intestinal & Hepatobiliary Cancer

Robotic radiosurgery treatment in liver tumors: Early experience from an Indian center

Authors

  • Debnarayan Dutta

    Department of Radiation Oncology, Amrita Institute of Medical Science, Kochi, Kerala

  • Sathiya Krishnamoorthy

    Department of Radiation Oncology, Global Hospital, Chennai, Tamil Nadu

  • H. Sudahar

    Department of Medical Physics, Apollo Speciality Hospital, Chennai, Tamil Nadu

  • M. Muthukumaran

    Department of Medical Physics, Apollo Speciality Hospital, Chennai, Tamil Nadu

  • T. Ramkumar

    Department of Surgical Gastroenterology, Apollo Speciality Hospital, Chennai, Tamil Nadu

  • Jayraj Govindraj

    Department of Radiology, Apollo Speciality Hospital, Chennai, Tamil Nadu

Source of Support: Nill.
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Abstract

Purpose: The purpose of this study is to report CyberKnife experience in hepatocellular carcinoma (HCC) and liver metastasis (LM). Materials and Methods: Fifty liver lesions in 31 consecutive patients with liver lesion [mean age 54.5 years (range 32-81 years), 77% were male patient, GTV <10cc in 5 patients, 11-90cc in 18 & >90cc in 8 patients respectively. Eighty percentage (25/31) had prior treatment (chemotherapy 18 patient & TACE in 7 patients). Dosage schedule was 21-45Gy/3# (mean PTV dose 33Gy, Prescription isodose 84%, target coverage 94%). Mean CI, nCI & HI were 1.19, 1.31 & 1.18 respectively. Mean liver dose was 5.4 Gy, 800 cc liver dose 11.1 Gy; Results: At mean follow-up of 12.5 months (range 1.9–44.6 months), 19 patients were expired and 12 were alive (nine patient with stable disease, two local progression, and one with metastasis). Median overall survival (OS) of all patients are 9 months (1.9–44.6 months), in HCC patients 10.5 months (2.1–44.6 months) and MT 6.5 months (1.9–24.6 months) respectively. Gr-I-II GI toxicities were in 11/50 (22%) patients. OS was influenced by PS (Karnofsky Performance Status 70–80 vs. 90–100: 9.9 vs. 16.4; P = 0.024), Child-Pugh (CP A/B vs. C: 23.6 vs. 6.5; P = 0.069), cirrhosis (only fatty liver vs. diffuse cirrhosis: 17.8 vs. 10.6; P = 0.003), prior treatment (no Rx vs. prior Rx: 30.1 vs. 8.2; P = 0.08), number of lesions (single vs. multiple: 16.4 vs. 6.9; P = 0.001), and target volume (<10 cc vs. >90 cc: 24.6 vs. 11.2; P = 0.03). Conclusion: Stereotactic body radiation therapy is a safe and effective treatment. Patient related factors such as performance status, Child-Pugh classification, cirrhosis status, prior treatment, number of liver lesion & target volume (GTV) influence the survival functions.

Key words

CyberKnife - Indian experience - liver tumor - robotic radiosurgery

Supplementary Material



Publication History

Article published online:
22 December 2020

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