Proton Beam Therapy for Hepatocellular Carcinoma Located Adjacent to the Alimentary Tract

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• 作者：Hidetsugu Nakayama M.D.^* ; Shinji Sugahara M.D.^* ; ^† ; ; Kuniaki Fukuda M.D.^‡ ; ; Masato Abei M.D.^‡ ; ; Junichi Shoda M.D.^‡ ; ; Hideyuki Sakurai M.D.^* ; Koji Tsuboi M.D.^* ; Yasushi Matsuzaki M.D.^§ ; ; Koichi Tokuuye M.D. ; Ph.D.^* ; ^† ; ; ^{Ktokuue@tokyo-med.ac.jp"" rel=""nofollow}
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2011
• 出版时间：15 July 2011
• 年：2011
• 卷：80
• 期：4
• 页码：992-995
• 全文大小：148 K

文摘

Purpose

To evaluate the safety and effectiveness of proton beam therapy for hepatocellular carcinoma (HCC) located adjacent to the alimentary tract.

Patients and Methods

Forty-seven patients (median age, 69 years; range, 43–82 years) who had HCC located within 2 cm of the alimentary tract underwent proton beam therapy. Liver damage according to the Child-Pugh classification was Class A in 35 patients, Class B in 9, and Class C in 3. Treatment protocols of the early 16 patients and the late 31 patients were 72.6 GyE in 22 fractions and 77 GyE in 35 fractions, respectively.

Results

During the median follow-up period of 23 months, 24 patients died; the remaining 23 patients were alive until September 2008. The median overall survival was 33.9 months (95 % confidence interval [CI], 10.8–57.0 months). Actuarial overall and local progression-free survival rates at 3 years were 50.0 % and 88.1 % , respectively. Grade 2 and 3 alimentary tract hemorrhage was observed in 3 (6.4 % ) and 1 (2.1 % ) patients, respectively.

Conclusions

Our proton beam therapy strategy for HCC located adjacent to the alimentary tract seems to be effective but should be performed with caution.