MRI-guided stereotactic radiation therapy for hepatocellular carcinoma: a feasible and safe innovative treatment approach

Luca Boldrini, Angela Romano, Silvia Mariani, Davide Cusumano, Francesco Catucci, Lorenzo Placidi, Gian Carlo Mattiucci, Giuditta Chiloiro, Francesco Cellini, Maria Antonietta Gambacorta, Luca Indovina, Vincenzo Valentini

Risultato della ricerca: Contributo in rivistaArticolo in rivista


Purpose: Hepatocellular carcinoma (HCC) in early stages benefits from local ablative treatments such as radiofrequency ablation (RFA) or transarterial chemoembolization (TACE). In this context, radiotherapy (RT) has shown promising results but has not been thoroughly evaluated. Magnetic resonance-guided RT (MRgRT) may represent a paradigm shifting improvement in stereotactic body radiotherapy (SBRT) for liver tumors. Methods: We retrospectively evaluated HCC patients treated on a hybrid low-tesla MRgRT unit. A total biologically effective dose (BED) > 100 Gy was delivered in 5 consecutive fractions, respecting the appropriate organs-at-risk constraints. Hybrid MR scans were used for treatment planning and cine MR was used for delivery gating. Patients were followed up for toxicity and treatment–response assessment. Results: Ten patients were enrolled, with a total of 12 lesions. All the lesions were irradiated with no interruptions. Six patients had already performed previous local therapies. Median follow-up after SBRT was 6.5 months (1–25). Two cases of acute toxicity were reported (G ≤ 2 according to CTCAE v4.0). At the time of the analysis, 90% of the population presented local control. Child–Pugh before and after treatment remained unchanged in all but one patient. Conclusion: MRgRT is a feasible and safe option showing favorable toxicity profile for HCC treatment.
Lingua originaleEnglish
pagine (da-a)2057-2068
Numero di pagine12
RivistaJournal of Cancer Research and Clinical Oncology
Stato di pubblicazionePubblicato - 2021


  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Hepatocellular carcinoma
  • Humans
  • Liver Neoplasms
  • Magnetic Resonance Imaging
  • Magnetic resonance-guided radiotherapy
  • Male
  • Multimodality treatment
  • Radiosurgery
  • Radiotherapy
  • Radiotherapy, Image-Guided
  • Retrospective Studies
  • Stereotactic body radiotherapy
  • Survival Rate
  • Treatment Outcome


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