{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T16:00:42Z","timestamp":1769097642967,"version":"3.49.0"},"reference-count":60,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Liver SBRT is a therapeutic option for the treatment of HCC in patients not eligible for other local therapies. We retrospectively report the outcomes of a cohort of consecutive patients treated with SBRT for HCC at the Montpellier Cancer Institute. Between March 2013 and December 2018, 66 patients were treated with image-guided liver SBRT using VMAT and real-time adaptive tumor gating in our institute. The main endpoints considered in this study were local control, disease-free survival, overall survival, and toxicity. The median follow-up was 16.8 months. About 66.7% had prior liver treatment. Most patients received 50 Gy in five fractions of 10 Gy. No patient had local recurrence. Overall survival and disease-free survival were, respectively, 83.9% and 46.7% at one year. In multivariate analysis, the diameter of the lesions was a significant prognostic factor associated with disease-free survival (HR = 2.57 (1.19\u20135.53) p = 0.02). Regarding overall survival, the volume of PTV was associated with lower overall survival (HR = 2.84 (1.14\u20137.08) p = 0.025). No grade 3 toxicity was observed. One patient developed a grade 4 gastric ulcer, despite the dose constraints being respected. Image-guided liver SBRT with VMAT is an effective and safe treatment in patients with inoperable HCC, even in heavily pre-treated patients. Further prospective evaluation will help to clarify the role of SBRT in the management of HCC patients.<\/jats:p>","DOI":"10.3390\/cancers13194853","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T12:29:14Z","timestamp":1632832154000},"page":"4853","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Image-Guided Liver Stereotactic Body Radiotherapy Using VMAT and Real-Time Adaptive Tumor Gating: Evaluation of the Efficacy and Toxicity for Hepatocellular Carcinoma"],"prefix":"10.3390","volume":"13","author":[{"given":"Marie","family":"Cantaloube","sequence":"first","affiliation":[{"name":"Montpellier Cancer Institute (ICM), University Federation of Radiation Oncology of Mediterranean Occitanie, Montpellier University, INSERM U1194 IRCM, 34298 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Castan","sequence":"additional","affiliation":[{"name":"Biometrics Unit ICM, Montpellier Cancer Institute, University Montpellier, 34298 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgane","family":"Creoff","sequence":"additional","affiliation":[{"name":"Montpellier Cancer Institute (ICM), University Federation of Radiation Oncology of Mediterranean Occitanie, Montpellier University, INSERM U1194 IRCM, 34298 Montpellier, France"},{"name":"Oncodoc, 34500 B\u00e9ziers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Prunaretty","sequence":"additional","affiliation":[{"name":"Montpellier Cancer Institute (ICM), University Federation of Radiation Oncology of Mediterranean Occitanie, Montpellier University, INSERM U1194 IRCM, 34298 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Bordeau","sequence":"additional","affiliation":[{"name":"Montpellier Cancer Institute (ICM), University Federation of Radiation Oncology of Mediterranean Occitanie, Montpellier University, INSERM U1194 IRCM, 34298 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6302-825X","authenticated-orcid":false,"given":"Morgan","family":"Michalet","sequence":"additional","affiliation":[{"name":"Montpellier Cancer Institute (ICM), University Federation of Radiation Oncology of Mediterranean Occitanie, Montpellier University, INSERM U1194 IRCM, 34298 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Assenat","sequence":"additional","affiliation":[{"name":"Service d\u2019Oncologie M\u00e9dicale, CHU St Eloi, 34000 Montpellier, 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Radiation Oncology of Mediterranean Occitanie, Montpellier University, INSERM U1194 IRCM, 34298 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Fenoglietto","sequence":"additional","affiliation":[{"name":"Montpellier Cancer Institute (ICM), University Federation of Radiation Oncology of Mediterranean Occitanie, Montpellier University, INSERM U1194 IRCM, 34298 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Azria","sequence":"additional","affiliation":[{"name":"Montpellier Cancer Institute (ICM), University Federation of Radiation Oncology of Mediterranean Occitanie, Montpellier University, INSERM U1194 IRCM, 34298 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9737-5655","authenticated-orcid":false,"given":"Olivier","family":"Riou","sequence":"additional","affiliation":[{"name":"Montpellier Cancer Institute (ICM), University Federation of Radiation Oncology of Mediterranean Occitanie, Montpellier University, INSERM U1194 IRCM, 34298 Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"key":"ref_1","unstructured":"Global Burden of Disease Liver Cancer Collaboration, Akinyemiju, T., Abera, S., Ahmed, M., Alam, N., Alemayohu, M.A., Allen, C., Al-Raddadi, R., Alvis-Guzman, N., and Amoako, Y. 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