New Radiation Procedure Targets Liver Malignancies

"If you can safely increase the dose of radiation delivered along with chemotherapy, you improve the patient's chance of responding to the therapy. Our prior studies, which involved more than 100 patients, have shown this to be the case," says Cornelius McGinn, M.D., a radiation oncologist and lead investigator on the U-M liver cancer study.

For 10 years, U-M researchers William Ensminger, M.D., Ph.D., Theodore Lawrence, M.D., Ph.D., and Randall Ten Haken, Ph.D., have investigated the use of focal liver irradiation along with chemotherapy delivered directly to the tumor via the hepatic artery. As a result of that research, they have developed a detailed formula for estimating the risk of radiation-induced liver disease for individual patients, based on the volume of normal liver tissue that is irradiated along with cancer cells.

The strategy works, McGinn says, by carefully targeting the tumor with external beam irradiation and excluding as much healthy liver tissue as possible. For each patient a dose is then selected which should maximize the potential benefit of radiation without exceeding an estimated 10 percent chance of developing radiation-induced liver disease.

At this point, 21 patients have been treated this way. The average radiation dose was significantly higher than the dose they would have would have been administered in the previous study, and only one patient has experienced a radiation-related complication. "This is probably the most aggressive non-surgical treatment a patient can receive for liver cancer in this country," McGinn says.

A paper detailing the U-M findings will be published in the June issue of the Journal of Clinical Oncology.

The next phase of the research involves further increasing the radiation dose in an additional group of patients (because the current formula has been found to over-estimate the risk of complications) and studying how much this regimen improves tumor control.