Dosimetric analysis of liver toxicity after liver metastasis stereotactic body radiation therapy

2017 ◽  
Vol 7 (5) ◽  
pp. e331-e337 ◽  
Author(s):  
Aisling Barry ◽  
Andrew McPartlin ◽  
Patricia Lindsay ◽  
Lisa Wang ◽  
James Brierley ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Liver Metastasis ◽  
Stereotactic Body Radiation Therapy ◽  
Liver Toxicity ◽  
Stereotactic Body Radiation ◽  
Dosimetric Analysis

Application of stereotactic body radiation therapy to cancer liver metastasis

2016 ◽  
Vol 379 (2) ◽  
pp. 225-229 ◽  
Author(s):  
Si-Yuan Zhang ◽  
Guang-Ying Zhu ◽  
Gong Li ◽  
Yi-Bao Zhang ◽  
Jian-Hao Geng
Keyword(s):  
Radiation Therapy ◽  
Liver Metastasis ◽  
Stereotactic Body Radiation Therapy ◽  
Stereotactic Body Radiation

The use of plasma microRNAs to predict toxicty following liver stereotactic body radiation therapy.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 245-245
Author(s):  
Kyle Clifford Cuneo ◽  
Yilun Sun ◽  
Matthew J Schipper ◽  
Muneesh Tewari ◽  
Theodore Steven Lawrence ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Radiation Therapy ◽  
Liver Function ◽  
Stereotactic Body Radiation Therapy ◽  
Liver Toxicity ◽  
Liver Tumors ◽  
Clinical Signs ◽  
Elastic Net ◽  
Stereotactic Body Radiation ◽  
Radiation Induced

245 Background: Stereotactic body radiation therapy (SBRT) is an effective treatment for patients with hepatocellular carcinoma or liver metastases. Predictive biomarkers for liver toxicity would allow for careful patient selection and the adaptation of therapy. Prior studies have shown specific miRNAs are elevated prior to clinical signs of toxin induced liver injury. We hypothesized that miRNAs can be used to predict radiation induced liver toxicity prior to clinical manifestations. Methods: As part of an IRB approved clinical trial (NCT01522937) patients with liver tumors underwent a split course of SBRT. All patients underwent liver function testing using indocyanine green clearance (ICG) followed by three SBRT fractions. One month later ICG was reassessed and two more fractions were given if the patient did not have a decline in liver function. Plasma samples were obtained at baseline and 1 month after finishing three of five SBRT fractions for 89 patients. For this exploratory analysis, we selected the 10 patients that had a 2+ point increase in Child-Turcotte-Pugh score within 6 months of completing therapy and 19 additional patients without toxicity. The levels of 752 miRNAs were quantified for each sample using qPCR. We then used a univariate tree based classifier and the elastic net with 10-fold cross validation to calculate the AUC for predicting liver toxicity in individual and small groups of miRNAs, respectively. Results: Several miRNAs were found to be potentially predictive of toxicity on univariate tree based classifier analysis including the liver specific microRNA miR.122.3p, the epithelial specific miR.141.3p and miR.200b.3p, the neuroendocrine related miR.375 and miR.217, and miR.125a.5p which plays a role in hepatitis and regulates ERBB2 and ERBB3 signaling. The elastic net model achieved a conservative AUC estimate of 0.74 +/- 0.04 using 69 baseline miRNAs and 0.76 +/- 0.06 using 11 mid-treatment miRNAs to predict toxicity. Conclusions: Our preliminary analysis of the miRNAome from 29 patients receiving liver SBRT shows promising results for the ability of these markers to select patients at risk for radiation induced liver toxicity. Further validation in a larger patient cohort is needed. Clinical trial information: NCT01522937.

Toward Personalized Radiation Therapy of Liver Metastasis: Importance of Serial Blood Biomarkers

2021 ◽  
pp. 315-325
Author(s):  
Ali Ajdari ◽  
Yunhe Xie ◽  
Christian Richter ◽  
Maximilian Niyazi ◽  
Dan G. Duda ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Liver Metastasis ◽  
Likelihood Ratio ◽  
Blood Count ◽  
Stereotactic Body Radiation Therapy ◽  
Complete Blood Count ◽  
Blood Biomarkers ◽  
Serial Blood ◽  
Lymphocyte Ratio ◽  
Stereotactic Body Radiation

PURPOSE To assess the added value of serial blood biomarkers in liver metastasis stereotactic body radiation therapy (SBRT). MATERIALS AND METHODS Eighty-nine patients were retrospectively included. Pre- and midtreatment blood samples were analyzed for potential biomarkers of the treatment response. Three biomarker classes were studied: gene mutation status, complete blood count, and inflammatory cytokine concentration in plasma. One-year local failure (LF) and 2-year overall survival (OS) were chosen as study end points. Multivariate logistic regression was used for response prediction. Added predictive benefit was assessed by quantifying the difference between the predictive performance of a baseline model (clinicopathologic and dosimetric predictors) and that of the biomarker-enhanced model, using three metrics: (1) likelihood ratio, (2) predictive variance, and (3) area under the receiver operating characteristic curve (AUC). RESULTS The most important predictors of LF were mutation in KRAS gene (hazard ratio [HR] = 2.92, 95% CI, [1.17 to 7.28], P = .02) and baseline and midtreatment concentration of plasma interleukin-6 (HR = 1.15 [1.04 to 1.26] and 1.06 [1.01 to 1.13], P = .01). Absolute lymphocyte count and platelet-to-lymphocyte ratio at baseline as well as neutrophil-to-lymphocyte ratio at baseline and before fraction 3 (HR = 1.33 [1.16 to 1.51] and 1.19 [1.09 to 1.30]) had the most significant association with OS ( P = .0003). Addition of baseline GEN and inflammatory plasma cytokine biomarkers in predicting LF, respectively, increased AUC by 0.06 (from 0.73 to 0.79) and 0.07 (from 0.77 to 0.84). In predicting OS, inclusion of midtreatment complete blood count biomarkers increased AUC from 0.72 to 0.80, along with significant boosts in likelihood ratio and predictive variance. CONCLUSION Inclusion of serial blood biomarkers leads to significant gain in predicting response to liver metastasis stereotactic body radiation therapy and can guide treatment personalization.

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