Future Oncol 2016-07-01
Conformal radiotherapy as a bridge to liver transplantation for hepatocellular carcinoma: is it safe?
ABSTRACT
AIM
To report a preliminary experience of conformal radiotherapy (CRT) as bridge to orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).
METHODS
Data of 12 patients undergoing CRT for HCC followed by OLT between 2012 and 2014 were reviewed.
RESULTS
CRT was used in a neoadjuvant or downstaging setting in nine and three patients, respectively. No radiation-related systemic toxicity was observed. Median blood loss and operating time were 1450 ml (600-4000) and 420 min (240-510), respectively. Four patients had diaphragmatic injury. Complete histological response was observed in six patients, and partial response in five. Seven patients developed severe postoperative morbidity including five anastomosis-related complications and one death.
CONCLUSION
CRT for HCC provides satisfactory histological response but may compromise OLT safety.
Related Questions
Should radiation be offered as a bridge to transplant? Should this depend on whether SBRT is feasible (i.e. is fractionated IMRT an appropriate option...
New answer by Radiation Oncologist at Mayo Clinic, Rochester (August 29, 2017)
Most HCC and cholangiocarcinoma patients who are transplant candidates are often also SBRT candidates. We have used SBRT to bridge patients to transplant. These patients often...