Researchers probe promising liver cancer treatment

By Joe Stuteville

The Phase I clinical trial at the IU Cancer Center uses extracranial stereotactic radioablation (SRA) as a potential new treatment for hepatocelluar carcinoma, a cancer that either originates in the liver, or for liver metastasis from other sites.

The technique evaluates the effects of escalating doses of radiation, which delivers highly focused, precisely targeted, radiation to destroy tumors with minimal damage to surrounding health tissues.

For this procedure, a 3-D computer generated grid system is used to precisely map the tumor location where the therapy will be directed. The patient is positioned in a specially fitted, lightweight body frame that allows perfect immobilization of the patient and stereotactic target localization which is essential in order to accurately deliver the radiation to the target with high precision.

The patient then receives multiple "shots" of photon beams produced by a linear accelerator, a technology similarly used in Gamma Knife radiosurgery, which has been highly effective in treating brain tumors.

"SRA may prove to be an option for patients with liver metastases who are not good candidates for conventional therapy," noted principal investigator Dr. Higinia Cardenes, associate clinical professor at the IU Department of Radiation Oncology.

"This technique is entirely non-invasive and makes it very attractive when compared with currently available therapies for the same patient population such as radio frequency ablation or chemoembolization, which is the delivery of drugs through the hepatic artery directly to the tumor followed by blocking the artery," Cardenes said.

Hepatocellular carcinoma is becoming a common clinical problem and its incidence is on the upswing in the United States because of the hepatitis C virus, which causes inflammation of the liver.

"In Phase I of the study, we are evaluating the toxicity of the therapy on patients," said Cardenes. "Our end goal is to determine if higher doses allowed with SRA kill the tumor without damaging healthy tissue or causing other side effects. We will closely monitor each patient's response, toxicity derived from the therapy and, of course, final outcome in terms of tumor control and patient's survival, in order to compare the effectiveness of this treatment with other therapies."

The SRA study also is being conducted at the University of Colorado Cancer Center.

For possible enrollment in the trial, contact Tia Whitford at 317-278-7267.

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