Open AccessLong‐term outcomes of proton beam therapy in patients with previously untreated hepatocellular carcinoma
Author(s) -
Fukuda Kuniaki,
Okumura Toshiyuki,
Abei Masato,
Fukumitsu Nobuyoshi,
Ishige Kazunori,
Mizumoto Masashi,
Hasegawa Naoyuki,
Numajiri Haruko,
Ohnishi Kayoko,
Ishikawa Hitoshi,
Tsuboi Koji,
Sakurai Hideyuki,
Hyodo Ichinosuke
Publication year - 2017
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.13145
Subject(s) - hepatocellular carcinoma , medicine , gastroenterology , adverse effect , liver cancer , stage (stratigraphy) , ascites , liver disease , cancer , multivariate analysis , oncology , biology , paleontology
Long‐term efficacy of proton beam therapy ( PBT ) remains unclear for patients with previously untreated hepatocellular carcinoma ( HCC ). We aimed to study the long‐term outcomes of PBT according to Barcelona Clinic Liver Cancer ( BCLC ) staging classifications in patients with previously untreated HCC . The major eligibility criteria of this observational study were an Eastern Cooperative Oncology Group performance status ( PS ) 0–2, Child–Pugh grade A or B, previously untreated HCC covered within an irradiation field, and no massive ascites. A total of 66.0–77.0 GyE was administered in 10–35 fractions. Local tumor control ( LTC ), defined as no progression in the irradiated field, progression‐free survival ( PFS ), and overall survival ( OS ) were assessed according to BCLC staging. From 2002 to 2009 at our institution, 129 patients were eligible. The 5‐year LTC , PFS , and OS rates were 94%, 28%, and 69% for patients with 0/A stage disease ( n = 9/21), 87%, 23%, and 66% for patients with B stage disease ( n = 34), and 75%, 9%, and 25% for patients with C stage disease ( n = 65), respectively. The 5‐year LTC and OS rates of 15 patients with tumor thrombi in major vessels were 90% and 34%, respectively. Multivariate analyses revealed that PS (0 versus 1–2) was a significant prognostic factor for OS . No grade 3 or higher adverse effects were observed. PBT showed favorable long‐term efficacies with mild adverse effects in BCLC stage 0 to C, and can be an alternative treatment for localized HCC especially when accompanied with tumor thrombi. This study was registered with UMIN Clinical Trials Registry ( UMIN 000025342).