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Shimizuguchi et al. Hepatoma Res 2020;6:66 Hepatoma Research
DOI: 10.20517/2394-5079.2020.51

Original Article Open Access

Stereotactic body radiation therapy for primary liver
tumors with adverse factors

Takuya Shimizuguchi , Jun Imamura , Simpei Hashimoto , Katsuyuki Karasawa 1
1
2
1
1 Department of Radiation Oncology, Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan.
2 Department of Hepatology, Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan.
Correspondence to: Dr. Takuya Shimizuguchi, Department of Radiation Oncology, Cancer and Infectious Diseases Center
Komagome Hospital, 3-18-22 Hon-komagome, Bunkyo-ku, Tokyo 113-8677, Japan. E-mail: shimizuguchi@cick.jp
How to cite this article: Shimizuguchi T, Imamura J, Hashimoto S, Karasawa K. Stereotactic body radiation therapy for primary
liver tumors with adverse factors. Hepatoma Res 2020;6:66. http://dx.doi.org/10.20517/2394-5079.2020.51
Received: 14 May 2020 First Decision: 22 Jun 2020 Revised: 13 Aug 2020 Accepted: 18 Aug 2020 Published: 12 Oct 2020

Academic Editors: Su Pin Choo, Guang-Wen Cao, David Tan Boon Harn Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: To test the efficacy and safety of liver stereotactic body radiation therapy (SBRT) in patients who harbor
Received: First Decision: Revised: Accepted: Published:
adverse factors.
Science Editor: Copy Editor: Production Editor: Jing Yu
Methods: We retrospectively evaluated the outcomes of liver SBRT in a single cancer center. We invented criteria
consisting of two physical factors and two tumor factors to measure the treatment difficulty in each case. The
clinical outcomes and toxicity were evaluated by stratification of the harboring factors.

Results: A total of 24 (23 hepatocellular carcinoma and 1 intrahepatic cholangiocarcinoma) patients were eligible
for this study, with a median follow-up duration of 18 months. Of all eligible patients, 21 patients (88%) had
one or more factors. The local control, progression-free survival, and overall survival rates for all patients at
2 years were 89%, 42%, and 76% respectively. In the patients with physical and tumor adverse factors, local
control/progression-free survival/overall survival rates at 2 years were 100%/42%/69% and 80%/23%/78%,
respectively. The subgroup of 11 patients with 2 or more factors showed comparable local control rate at 2 years
to the subgroup of 13 patients with 0 to 1 factors (100% vs. 86%, P = 0.59). One patient (4.2%) experienced a
decline in the Child-Pugh score by 2 points at 3 months after the treatment. Grade 2 to 3 gastrointestinal toxicity
was observed in three patients.

Conclusion: SBRT showed a high local control rate with acceptable toxicity for the group of liver cancer patients
harboring both physical and tumor adverse factors as long as conducted following patient selection and dose
constraints that were used in this study.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
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