Title: Stereotactic body radiation therapy as an effective local treatment for advanced
hepatocellular carcinoma patients with inferior vena cava and right atrial tumor thrombus
Version: 1 Date: 24 Aug 2022
Reviewer's report:
This is an interesting paper examining the results of SBRT for HCC with tumor in vein involving
the IVC and right atrium. This is a small population of very advanced HCC with few treatment
options and grim prognosis. The authors document in this retrospective analysis that with high
dose SBRT these patients appear to fair better than expected with local control of 80% and a 1-
and 2-year survival rates of 60% and 27% respectively. This is certainly an encouraging signal
of efficacy and I agree with their statement that high-dose radiotherapy should be explored more
in depth in this clinical scenario.
The manuscript requires some linguistic editing.
Figure 2 shows too many images that do not had much important information. It should be
shortened considerably and focused on a message.
There is important information that has not been reported. The authors should provide the
patients performance status at initiation of SBRT, liver function at initiation of SBRT (Child
Pugh score, albi score).
The authors should provide Organs-At-Risk (OAR) constraints for the radiation plans. They
should also provide additional information about the patients who died of upper GI bleeding.
This should include the site of bleeding, and the maximal dose point delivered to the esophagus,
stomach and duodenum.
Title: Stereotactic body radiation therapy as an effective local treatment for advanced
hepatocellular carcinoma patients with inferior vena cava and right atrial tumor thrombus
Version: 1 Date: 24 Aug 2022
Reviewer's report:
This is an interesting paper examining the results of SBRT for HCC with tumor in vein involving
the IVC and right atrium. This is a small population of very advanced HCC with few treatment
options and grim prognosis. The authors document in this retrospective analysis that with high
dose SBRT these patients appear to fair better than expected with local control of 80% and a 1-
and 2-year survival rates of 60% and 27% respectively. This is certainly an encouraging signal
of efficacy and I agree with their statement that high-dose radiotherapy should be explored more
in depth in this clinical scenario.
The manuscript requires some linguistic editing.
Figure 2 shows too many images that do not had much important information. It should be
shortened considerably and focused on a message.
There is important information that has not been reported. The authors should provide the
patients performance status at initiation of SBRT, liver function at initiation of SBRT (Child
Pugh score, albi score).
The authors should provide Organs-At-Risk (OAR) constraints for the radiation plans. They
should also provide additional information about the patients who died of upper GI bleeding.
This should include the site of bleeding, and the maximal dose point delivered to the esophagus,
stomach and duodenum.
Please review this paper.
user
Title: Stereotactic body radiation therapy as an effective local treatment for advanced
hepatocellular carcinoma patients with inferior vena cava and right atrial tumor thrombus
Version: 1 Date: 24 Aug 2022
Reviewer's report:
This is an interesting paper examining the results of SBRT for HCC with tumor in vein involving
the IVC and right atrium. This is a small population of very advanced HCC with few treatment
options and grim prognosis. The authors document in this retrospective analysis that with high
dose SBRT these patients appear to fair better than expected with local control of 80% and a 1-
and 2-year survival rates of 60% and 27% respectively. This is certainly an encouraging signal
of efficacy and I agree with their statement that high-dose radiotherapy should be explored more
in depth in this clinical scenario.
The manuscript requires some linguistic editing.
Figure 2 shows too many images that do not had much important information. It should be
shortened considerably and focused on a message.
There is important information that has not been reported. The authors should provide the
patients performance status at initiation of SBRT, liver function at initiation of SBRT (Child
Pugh score, albi score).
The authors should provide Organs-At-Risk (OAR) constraints for the radiation plans. They
should also provide additional information about the patients who died of upper GI bleeding.
This should include the site of bleeding, and the maximal dose point delivered to the esophagus,
stomach and duodenum.
assistant