Stereotactic body radiotherapy for unresectable hepatocellular carcinoma: A population based analysis of tumors up to 15 cm.
Bibliographic record
Abstract
322 Background: Stereotactic body radiotherapy (SBRT) has an emerging role for patients with hepatocellular (HCC). The purpose of this study is to describe the efficacy of HCC SBRT at a population level without any tumor size restriction. Methods: A retrospective study of the first 49 HCC patients treated with SBRT between March 2011-July 2015 at the British Columbia Cancer Agency was conducted. All patients were either ineligible for or failed standard local therapies (partial hepatectomy, radiofrequency ablation, percutaneous ethanol injection, transarterial chemoembolization, or radioembolization) and discussed in a multidisciplinary rounds setting. Local control (LC), progression free survival (PFS) (defined as freedom from failure elsewhere in the liver) and overall survival (OS) were analyzed at 1 and 2 years. Changes to Child’s Pugh (CP) score at 3 months post-SBRT were also analyzed. Results: Median follow-up was 14 months with 35 patients (71%) alive at last follow-up. Fifty-two separate HCC lesions were treated with a median size of 4.2 cm (range: 1.3-15.6 cm) and a planning treatment volume (PTV) of 114 cm3 (range: 22-1776 cm3). Over half of the lesions (55%) were ≥ 4cm. Thirty-six patients (74%) had previous local therapies. Prior to SBRT, 57% of patients were CP A5, 33% were CP B6, 8% were CP B7, and 1 patient (2%) was CP B8. At 3 months post-SBRT, 35% of patients had an increased CP score, with a mean increase of 1.8 points. The most common dose and fractionation was 45Gy in 3 or 5 fractions. Median V90 (dose to 90% of the PTV) was 99.8% (range: 74.1-100%). LC for all patients was 96% at 1 and 2 years. LC was comparable between moderate to large tumors ( ≥ 4cm) and those < 4cm (1 and 2 year LC: 96% for ≥ 4cm vs 95% for < 4cm). OS for all patients at 1 year was 67% and 62% at 2 years. PFS was 53% and 38% at 1 and 2 years respectively. The median PFS was 13.7 months with 13 patients (27%) undergoing further local treatment due to regional progression including 4 patients who had liver transplants. Conclusions: SBRT provides high local control for patients with HCC of even moderate to large size. Regional progression is prominent in HCC patients and SBRT does not appear to preclude further local treatments.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".