Expanding the Use of SBRT as a Bridge to Liver Transplantation
Nima Nabavizadeh, MD, and his team at the Oregon Health and Science University (OHSU) Department of Radiation Medicine are prospectively studying whether stereotactic body radiation therapy (SBRT) can be safely used to help patients with hepatocellular carcinoma (HCC) and advanced cirrhosis as they await a liver transplant. These fragile cancer patients have historically been excluded from receiving liver-directed therapies such as SBRT due of the fear of causing further damage, and Dr. Nabavizadeh’s study is an important step in generating the evidence necessary to demonstrate that SBRT is a safe and practical method to bridge them to the liver transplant they need to survive.
With the grant from ROI, Dr. Nabavizadeh’s team is prospectively:
- Evaluating the ability of SBRT to successfully bridge patients to a liver transplant, particularly in patients with advanced cirrhosis at baseline.
- Assessing treatment-related toxicity and quality of life of the HCC patients receiving SBRT.
- Examining the histologic effects of SBRT in the livers removed from HCC patients who are successfully bridged to transplant.
The team at OHSU recently published the results of their institutional retrospective study about using SBRT to treat HCC patients with varying degrees of cirrhosis, which showed that patients with advanced cirrhosis did not have a significantly higher rate of toxicity compared to other patients in the study. These promising results provide a strong basis for Dr. Nabavizadeh’s ROI-funded pilot study, which is the first to prospectively assess the use of SBRT in HCC patients with advanced cirrhosis and will ultimately contribute to the development of a larger-scale multi-institutional clinical trial. Additional members of the multi-disciplinary liver team working on the pilot study are: Kristian Enestvedt, MD, Christian Lanciault, MD, PhD, Alice Fung, MD, Khashayar Farsad, MD, PhD, Joseph Ahn, MD, MS, FACG; Yiyi Chen, PhD, and Ramtin Rahmani.