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@ARTICLE{Gerum:147645,
      author       = {S. Gerum and C. Heinz and C. Belka and F. Walter and P. M.
                      Paprottka and E. N. De Toni and F. Roeder$^*$},
      title        = {{S}tereotactic body radiotherapy in patients with
                      hepatocellular carcinoma in a multimodal treatment
                      setting.},
      journal      = {Strahlentherapie und Onkologie},
      volume       = {196},
      number       = {4},
      issn         = {1439-099X},
      address      = {Heidelberg},
      publisher    = {Springer Medizin},
      reportid     = {DKFZ-2019-02636},
      pages        = {334-348},
      year         = {2020},
      note         = {2020 Apr;196(4):334-348#LA:E055#},
      abstract     = {Retrospective evaluation of stereotactic body radiation
                      therapy (SBRT) in patients with hepatocellular carcinoma
                      (HCC).We retrospectively analyzed 36 patients (45 lesions)
                      treated between 2011 and 2017. Twenty-seven had previous
                      treatments. Current treatment consisted of SBRT alone
                      (n = 15) or selective transarterial chemoembolization
                      (TACE) followed by SBRT to the same lesions (n = 21).
                      Eight patients received additional local treatments to
                      different lesions. Liver function was predominantly
                      moderately restricted (Child A: 29, Child B: 6, Child C:
                      1). Treatment planning was based on 4D-computed tomography,
                      dose/fractionation varied depending on location and size,
                      most commonly 3 fractions of 12.5 Gy $(65\%$ isodose)
                      and 5 fractions of 8 Gy $(80\%$ isodose).Median follow-up
                      was 15 months. Local recurrence was observed in 3 lesions
                      $(7\%),$ resulting in 1‑and 2‑year local control rates
                      of $93\%.$ The only significantly predicting factor was the
                      use of abdominal compression. New hepatic lesions occurred
                      in 19 patients $(52\%),$ 1‑ and 2‑year
                      freedom-from-hepatic-failure (FFHF) was $39\%$ and $32\%,$
                      respectively. Only the number of treated lesions was
                      predictive for FFHF. Sixteen patients have died, resulting
                      in 1‑ and 2‑year overall survival (OS) of $64\%$ and
                      $41\%,$ respectively, significantly impacted by the number
                      of treated lesions and Child-Pugh class. Severe acute and
                      late toxicity (≥grade 3) was observed in $3\%$ and $8\%,$
                      respectively. 6 patients $(17\%)$ received liver
                      transplantation (OLT) after SBRT, of whom 5 showed
                      pathological complete remission.SBRT (±TACE) in highly
                      pretreated HCC is effective and associated with excellent LC
                      and low toxicity. SBRT may be used as definitive or bridging
                      treatment prior to OLT. Patients with multifocal lesions
                      have significantly decreased 1‑ and 2‑year FFHF and OS.},
      cin          = {E055},
      ddc          = {610},
      cid          = {I:(DE-He78)E055-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31732784},
      doi          = {10.1007/s00066-019-01540-8},
      url          = {https://inrepo02.dkfz.de/record/147645},
}