Determination and comparison of radiotherapy dose responses for hepatocellular carcinoma and metastatic colorectal liver tumours

摘要

Objective: The purpose of this study was to seek radiation dose responses separately for primary hepatocellular carcinoma (HCC) and metastatic (MET) colorectal liver tumours to establish tumour control probabilities (TCPs) for radiotherapy (RT) of liver tumours. Methods: The records of 36 HCC and 26 MET colorectal liver tumour patients were reviewed. The median dose per fraction and total dose were 4Gy (2-10 Gy) and 52Gy (29-83 Gy) for the HCC group and 3.6Gy (2.0-13.0 Gy) and 55Gy (30-80Gy) for the MET group, respectively. Median tumour diameter was 6.6 cm (3.0- 18.0 cm) and 5.0cm (1.0-13.0cm) for the HCC and MET groups, respectively. A logistic TCP model was fitted to the response data for each group using the maximum likelihood method. Results: 50% and 90% probabilities of 6-month local control were estimated to be achievable by 2Gy per fraction equivalent doses (a/ b510 Gy) of 53Gy and 84 Gy for the HCC group and 70Gy and 95 Gy for the MET group, respectively. Actuarial 1-year local control for the HCC and MET groups was 65% (45- 85%) and 32% (6 - 58%), respectively, whereas median time to failure was 543 days (374-711 days) and 183 days (72-294 days), respectively. Conclusion: Dose-response relationships were found and modelled for the HCC and MET patient groups, with a higher dose required to control MET tumours. RT offers better local control for HCC than for MET colorectal liver tumours at our institution. Advances in knowledge: An improved understanding of radiation dose-response relationships for primary and MET colorectal liver tumours will help inform future dose prescriptions.