Hepatocellular Carcinoma
Conditions
Keywords
SBRT, TACE, TAE
Brief summary
The trial is a multicentre, prospective, randomised controlled, unblinded, parallel-group superiority trial of SBRT versus standard TAE/TACE for the curative treatment of inoperable HCC treated with a TAE/TACE incomplete cycle.
Detailed description
In this phase III study patients with inoperable HCC single nodule no more 5 cm or 1- 3 nodules no more 3 cm in diameter after incomplete TAE or TACE, are randomized to stereotactic radiotherapy in 3 or 6 daily fractions or to a new cycle of TAE or TACE. A total of 80 patients (40 in each arm) will be recruited into the trial over a 2 years period and will be randomised on an equal basis to either SBRT or TAE/TACE. The follow-up period will be finished 1.5 years after the final patient is randomised.
Interventions
Patients with single nodule no more 5 cm or 1- 3 nodules no more 3 cm in diameter after incomplete TAE or TACE, are randomized to stereotactic radiotherapy in 3 or 6 daily fractions
Patients with single nodule no more 5 cm or 1- 3 nodules no more 3 cm in diameter after incomplete TAE or TACE, are randomized to a new cycle of TAE or TACE
Sponsors
Study design
Eligibility
Inclusion criteria
* Age \>18 years * Karnofsky index \>70% * Child-Turgotte-Pugh A or B liver score. * An initial diagnosis of primary HCC or recurrence. * A technically unresectable lesion or medically contraindicated surgery or a case in which surgery was declined. * HCC (single nodule ≤ 5 cm or max 3 nodules ≤ 3 cm) diagnosed by histology or non-invasive EASL criteria * Baseline CT or MRI and bone scan without evidence of radiologically definable major vascular invasion or extrahepatic disease * Hb \>10.5.0 g/%, WBC \>3.000 cells/mm3, platelets \>50.000 cells/mm3, bilirubin \<2 mg/dl, aspartate and alanine aminotransferase levels \<5 times upper normal limit, and prothrombin time-international normalized ratio ≤ 2; * Serum creatinine \<1.7 mg/dl * Previously incomplete TAE or TACE with radiologically defined residual disease. * Informed consent
Exclusion criteria
* Extrahepatic disease and refractory ascites. * Previous abdominal radiation therapy (RT) * Hemorrhage/bleeding event = Grade 3 within 4 weeks of enrollment in the study. * Pregnant or breastfeeding patients. * Patients with uncontrolled infections or HIV seropositive patients. * Mental conditions rendering the patient incapable to understand the nature, scope, and consequences of the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Local control (efficacy of SBRT in selected HCC patients with an incomplete response after TACE/TAE) | 1.5 years | This is a study designed to evaluate the efficacy of SBRT in selected HCC patients with an incomplete response after TACE/TAE. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| progression free-survival | 1.5 years | — |
| overall survival | 1.5 years | — |
| toxicity (incidence of acute and late complications) | 1.5 years | incidence of acute and late complications |
Countries
Italy