Proton beam therapy for hepatocellular carcinoma |
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Authors: | Hidetsugu Nakayama MD PhD Shinji Sugahara MD PhD Mari Tokita BA Kuniaki Fukuda MD PhD Masashi Mizumoto MD PhD Masato Abei MD PhD Junichi Shoda MD PhD Hideyuki Sakurai MD PhD Koji Tsuboi MD PhD Koichi Tokuuye MD PhD |
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Affiliation: | 1. Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan;2. Fax: (011) 81‐29‐853‐7102;3. Department of Radiation Oncology, Alpert Medical School of Brown University, Providence, Rhode Island;4. Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan;5. Department of Radiology, Tokyo Medical University, Shinjuku, Tokyo, Japan |
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Abstract: | BACKGROUND: The authors have published a series of studies evaluating the safety and efficacy of proton beam therapy for the treatment of hepatocellular carcinoma in a variety of clinical settings. In the current study, they retrospectively reviewed their entire experience treating hepatocellular carcinoma patients with proton beam therapy at their hospital‐based facility at the University of Tsukuba. METHODS: From November 2001 to December 2007, 333 patients with hepatocellular carcinoma were treated with proton beam therapy at the University of Tsukuba. A total of 318 patients were included in this study. Total dose delivered and fractionation scheme were determined by protocols that varied based on location of tumor. Survival rates and prognostic factors were assessed. RESULTS: Overall actuarial survival rates at 1‐year, 3‐years, and 5‐years were 89.5% (95% confidence interval [95% CI], 85.7‐93.1%), 64.7% (95% CI, 56.6‐72.9%), and 44.6% (95% CI, 29.7‐59.5%), respectively. Child‐Pugh liver function (hazards ratio [HR], 2.84; P < .01), T stage (HR, 1.94; P < .05), performance status (HR, 2.12; P < .01), and planning target volume (HR, 2.12; P < .05) significantly impacted survival. The 3‐year and 5‐year survival rates were 69.1% (95% CI, 59.9‐78.3%) and 55.9% (95% CI, 41.5‐70.3%), respectively, for patients with Child‐Pugh A disease and 51.9% (95% CI, 32.3‐71.5%) and 44.5% (95% CI, 23.1‐65.8%), respectively, for patients with Child‐Pugh B disease. The actuarial survival rates of patients with Child‐Pugh class A were statistically different between groups of planned target volume ≤125 mL and >125 mL (P < .05). CONCLUSIONS: The authors have shown proton beam therapy to be both safe and effective for the treatment of patients with hepatocellular carcinoma. They strongly recommend the consideration of proton beam therapy in patients for whom other treatment options are risky or contraindicated. Cancer 2009. © 2009 American Cancer Society. |
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Keywords: | proton hepatocellular carcinoma radiotherapy liver cancer particle |
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