6 research outputs found
Stereotactic body radiation therapy for primary liver tumors with adverse factors
Aim: To test the efficacy and safety of liver stereotactic body radiation therapy (SBRT) in patients who harbor adverse factors.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
Appropriate endpoints for stereotactic body radiotherapy for bone metastasis: Classification into five treatment groups
Treatment of bone metastasis using stereotactic body radiotherapy (SBRT) is being widely used in clinical practice. The reported clinical advantages of SBRT include high pain and local control rates, high response rates against bone metastasis from radio-resistant tumors, and safe re-irradiations. Although most reports in the literature use local control as the primary treatment endpoint, this endpoint is not appropriate because local control does not relate directly to patient benefit. Herein, we proposed five pathophysiology-based patient groups, as well as appropriate endpoints for each group
Whole-liver radiotherapy for diffuse liver metastases improves liver enzymes and related factors
Clinical outcomes in transplantâeligible patients with relapsed or refractory diffuse large Bâcell lymphoma after secondâline salvage chemotherapy: A retrospective study
Abstract Objective The prognosis of patients with relapsed or refractory (R/R) diffuse large Bâcell lymphoma (DLBCL) is poor. Although patients who fail firstâline salvage chemotherapy are candidates for secondâline salvage chemotherapy, the optimal treatment strategy for these patients has not yet been established. Methods The present, singleâcenter, retrospective study included transplantâeligible patients with R/R DLBCL who received secondâline salvage chemotherapy with curative intent. Results Seventyâsix patients with R/R DLBCL received secondâline salvage chemotherapy. Eighteen (23.7%) patients were responders to the firstâline salvage chemotherapy. The overall response rate was 39.5%, and overall survival (OS) was significantly longer in patients who responded to secondâline salvage chemotherapy than those who did not. Fortyâone patients who proceeded to potentially curative treatment (autologous hematopoietic stem cell transplantation [ASCT], chimeric antigen receptor [CAR] Tâcell therapy, or allogeneic hematopoietic stem cell transplantation) had a better prognosis than those who did not. Among the 46 patients who failed to respond to the secondâline salvage regimen, only 18 (39.1%) could proceed to the curative treatments. However, among the 30 patients who responded to the secondâline salvage regimen, 23 (76.7%) received one of the potentially curative treatments. Among 34 patients who received CAR Tâcell therapy, OS was significantly longer in those who responded to salvage chemotherapy immediately prior to CAR Tâcell therapy than in those who did not respond. In contrast, the number of prior lines of chemotherapy was not identified as a statistically significant prognostic factor of survival. No significant difference was detected in OS between patients receiving ASCT and those receiving CAR Tâcell therapy after the response to secondâline salvage chemotherapy. Discussion In this study, we demonstrated that chemosensitivity remained a crucial factor in predicting survival outcomes following CAR Tâcell therapy irrespective of the administration timing, and that both ASCT and CAR Tâcell therapy were acceptable after the response to secondâline salvage chemotherapy