title: Stereotactic body radiotherapy for primary hepatic malignancies - Report of a phase I/II institutional study.
abstract: To report outcomes and toxicities of a single-institution phase I/II study of stereotactic body radiotherapy (SBRT) in the treatment of unresectable hepatocellular cancer (HCC) and intrahepatic cholangiocarcinoma (IHC).
  
  
  
  Patients with Child-Pugh score less than 8 were eligible. A total of 32 lesions in 26 patients were treated with SBRT. Kaplan-Meier survival analysis was performed. Toxicities were graded by CTCAEv4 criteria and response was scored by EASL guidelines.
  
  
  
  Median prescribed dose was 55Gy (range 40-55Gy) delivered in 5 fractions. Mean tumor diameter was 5.0cm and mean GTV was 107cc. Median follow-up was 8.8months with a median survival of 11.1months, and one-year overall survival was 45%. Overall response rate was 42% and one-year local control was 91%. Nine patients experienced a decline in Child-Pugh class following treatment, and two grade 5 hepatic failure toxicities occurred during study follow-up.
  
  
  
  Primary hepatic malignancies not amenable to surgical resection portend a poor prognosis, despite available treatment options. Though radiation-induced liver disease (RILD) is rare following SBRT, this study demonstrates a risk of hepatic failure despite adherence to protocol constraints.
authors: Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA.
authors: Ashley A
authors: AA
authors: Weiner
authors: Department of Radiation Oncology, University of Colorado School of Medicine, Colorado Springs, CO, USA.
authors: Jeffrey
authors: J
authors: Olsen
authors: Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
authors: Daniel
authors: D
authors: Ma
authors: Missouri Baptist Medical Center, St. Louis, MO, USA.
authors: Pawel
authors: P
authors: Dyk
authors: Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA.
authors: Todd
authors: T
authors: DeWees
authors: Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA.
authors: Robert J
authors: RJ
authors: Myerson
authors: Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA. Electronic address: pparikh@radonc.wustl.edu.
authors: Parag
authors: P
authors: Parikh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: Cholangiocarcinoma; Hepatocellular carcinoma; SBRT