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HOME > J Liver Cancer > Volume 17(1); 2017 > Article
Original Article Selection of Proper Modality in Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma
Seo hee Choi, Joong Yeol Woo, Jinsil Seong
Journal of Liver Cancer 2017;17(1):45-53
DOI: https://doi.org/10.17998/jlc.17.1.45
Published online: March 31, 2017
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Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
Corresponding author:  Jinsil Seong,
Email: jsseong@yuhs.ac

Background
/Aims: As the optimal stereotactic body radiation therapy (SBRT) modality for hepatocellular carcinoma (HCC) has not been confirmed, we aimed herein to provide a practical guideline by our retrospective review.
Methods
Thirty-nine patients with primary HCC who underwent liver SBRT via 3 modalities (helical tomotherapy [HT]: 22, volumetric modulated arc therapy [VMAT]: 13, Cyberknife: 4) at our institution between July 2014 and July 2015 were included. Modalities were compared with regard to dose conformity index (CI), homogeneity index (HI), clinical results, and patient compliance.
Results
VMAT SBRT had favorable conformity (CI: 0.7±0.2), homogeneity (HI: 1.1±0.0), and shortest treatment time (100.2±26.1 seconds). HT SBRT yielded good dosimetric outcomes, especially in conformity (CI: 1.0±0.2). Although the Cyberknife SBRT synchrony system allowed real-time tumor targeting, the treatment time was longest (3,015.0±447.3 seconds), invasive pre-treatment procedures were required, and the HI (1.3±0.0) was lowest.
Conclusions
All 3 modalities yielded competent dosimetric planning parameters. VMAT SBRT was most appropriate for tumors with residual lipiodol or patients with poor conditions. HT SBRT is available for multiple or irregular targets. Cyberknife SBRT is recommended for carefully selected patients and tumors indicated for sono-guided fiducial insertion.


JLC : Journal of Liver Cancer