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Link to original content: https://pubmed.ncbi.nlm.nih.gov/29580046
Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma - PubMed Skip to main page content
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. 2018 Mar;36(1):25-34.
doi: 10.3857/roj.2017.00409. Epub 2018 Mar 29.

Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

Jeong Il Yu  1 , Gyu Sang Yoo  1 , Sungkoo Cho  1 , Sang Hoon Jung  1 , Youngyih Han  1   2 , Seyjoon Park  1 , Boram Lee  1 , Wonseok Kang  3 , Dong Hyun Sinn  3 , Yong-Han Paik  3 , Geum-Youn Gwak  3 , Moon Seok Choi  3 , Joon Hyeok Lee  3 , Kwang Cheol Koh  3 , Seung Woon Paik  3 , Hee Chul Park  1   2
Affiliations

Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

Jeong Il Yu et al. Radiat Oncol J. 2018 Mar.

Abstract

Purpose: This study aimed to evaluate the initial outcomes of proton beam therapy (PBT) for hepatocellular carcinoma (HCC) in terms of tumor response and safety.

Materials and methods: HCC patients who were not indicated for standard curative local modalities and who were treated with PBT at Samsung Medical Center from January 2016 to February 2017 were enrolled. Toxicity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Tumor response was evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST).

Results: A total of 101 HCC patients treated with PBT were included. Patients were treated with an equivalent dose of 62-92 GyE10. Liver function status was not significantly affected after PBT. Greater than 80% of patients had Child-Pugh class A and albumin-bilirubin (ALBI) grade 1 up to 3-months after PBT. Of 78 patients followed for three months after PBT, infield complete and partial responses were achieved in 54 (69.2%) and 14 (17.9%) patients, respectively.

Conclusion: PBT treatment of HCC patients showed a favorable infield complete response rate of 69.2% with acceptable acute toxicity. An additional follow-up study of these patients will be conducted.

Keywords: Hepatocellular carcinoma; Proton; Radiotherapy; Response; Toxicity.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Changes in liver function status. Liver function was assessed by Child-Pugh score (A) and the albumin-bilirubin grade (B) before proton beam therapy (PBT), during PBT, and at 1- and 3-month follow-up visits after completion of PBT.
Fig. 2.
Fig. 2.
Esophagogastroduodenoscopy (EGD) findings before and after proton beam therapy (PBT). Two newly developed gastroduodenal ulcers were detected by EGD during follow-up, and one patient showed melena and hematochezia 3 months after PBT. CAG, chronic atrophic gastritis; CSG, chronic superficial gastritis; PHG, portal hypertensive gastropathy; EV, esophageal varices; GV, gastric varices.
Fig. 3.
Fig. 3.
Proton beam therapy (PBT)-related duodenal ulcer. Isodose curves of PBT planning and esophagogastroduodenoscopy detection of a duodenal ulcer.
Fig. 4.
Fig. 4.
Accumulated complete response rate as maximum infield response according to mRECIST criteria. The characteristic arterial phase enhancement of hepatocellular carcinoma (white arrows) was disappeared after proton beam therapy (black arrows).
Fig. 5.
Fig. 5.
Several cases showing complete response (CR) according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria after proton beam therapy.
See this image and copyright information in PMC

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