Abstract # 1072 Phase I Study Of Stereotactic Radiotherapy For Unresectable Hepatocellular Carcinoma And Intrahepatic Cholangiocarcinoma

Presenter: Dawson, Laura

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Eligible patients had unresectable or medically inoperable HCC or intrahepatic CC, liver enzymes < 6 fold higher than normal, platelet count > 80, 000 bil/L, Child-Pugh liver score A, > 800 cc of uninvolved liver, and KPS performance status ≥ 60. Patients were stratified based on the effective liver volume irradiated (Veff), calculated from the liver minus GTV DVH (low <20%, mid 20-50%, high 50-80%). Patients were treated with breath hold if feasible and daily IGRT. SRT was delivered in 6 fractions. The dose was individualized to maintain the same estimated risk of classic radiation-induced liver disease (RILD) at 3 levels (I: 5% risk, II: 10% risk, III: 20% risk), with a maximal dose of 60 Gy in 6 fractions. The RILD risk was estimated from the University of Michigan Lyman NTCP model for RILD in primary liver cancer, with a correction for dose per fraction, assuming α/β = 2.5 Gy. Escalation to each level occurred once at least 3 patients had been irradiated without RILD or CTC3.0 grade 4/5 toxicity < 3 months following SRT at the prior level.

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