This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chiba, T. Articles by Akine, Y. Search for Related Content PubMed PubMed Citation Articles by Chiba, T. Articles by Akine, Y.

Proton Beam Therapy for Hepatocellular Carcinoma: A Retrospective Review of 162 Patients

Authors' Affiliations: Departments of ¹ Gastroenterology and ² Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan

Requests for reprints: Koichi Tokuuye, Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, Japan. Phone: 81-29-853-7124; Fax: 81-29-853-7102; E-mail: ktokuue{at}pmrc.tsukuba.ac.jp.

Purpose: We present results of patients with hepatocellular carcinoma (HCC) treated with proton beam therapy.

Experimental Design: We reviewed 162 patients having 192 HCCs treated from November 1985 to July 1998 by proton beam therapy with or without transarterial embolization and percutaneous ethanol injection. The patients in the present series were considered unsuitable for surgery for various reasons, including hepatic dysfunction, multiple tumors, recurrence after surgical resection, and concomitant illnesses. The median total dose of proton irradiation was 72 Gy in 16 fractions over 29 days.

Results: The overall survival rate for all of the 162 patients was 23.5% at 5 years. The local control rate at 5 years was 86.9% for all 192 tumors among the 162 patients. The degree of impairment of hepatic functions attributable to coexisting liver cirrhosis and the number of tumors in the liver significantly affected patient survival. For 50 patients having least impaired hepatic functions and a solitary tumor, the survival rate at 5 years was 53.5%. The patients had very few acute reactions to treatments and a few late sequelae during and after the treatments.

Conclusions: Proton beam therapy for patients with HCC is effective, safe, well tolerable, and repeatable. It is the useful treatment mode for either cure or palliation for patients with HCC irrespective of tumor size, tumor location in the liver, insufficient feeding of the tumor with arteries, presence of vascular invasion, impaired hepatic functions, and coexisting intercurrent diseases.

Key Words: Hepatocellular carcinoma • Proton beam therapy • Bragg peak • Local tumor control • Survival • Treatment sequelae

This article has been cited by other articles:

				S. Krishnan, L. A. Dawson, J. Seong, Y. Akine, S. Beddar, T. M. Briere, C. H. Crane, and F. Mornex Radiotherapy for Hepatocellular Carcinoma: An Overview Ann. Surg. Oncol., April 1, 2008; 15(4): 1015 - 1024. [Full Text] [PDF]

				R. V. Tse, M. Hawkins, G. Lockwood, J. J. Kim, B. Cummings, J. Knox, M. Sherman, and L. A. Dawson Phase I Study of Individualized Stereotactic Body Radiotherapy for Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma J. Clin. Oncol., February 1, 2008; 26(4): 657 - 664. [Abstract] [Full Text] [PDF]

				REFERENCES J. ICRU, December 1, 2007; 7(2): 189 - 210. [PDF]

				M. Mizumoto, K. Tokuuye, S. Sugahara, M. Hata, N. Fukumitsu, T. Hashimoto, K. Ohnishi, K. Nemoto, K. Ohara, Y. Matsuzaki, et al. Proton Beam Therapy for Hepatocellular Carcinoma with Inferior Vena Cava Tumor Thrombus: Report of Three Cases Jpn. J. Clin. Oncol., June 6, 2007; (2007) hym038v1. [Abstract] [Full Text] [PDF]

				D. Schulz-Ertner and H. Tsujii Particle Radiation Therapy Using Proton and Heavier Ion Beams J. Clin. Oncol., March 10, 2007; 25(8): 953 - 964. [Abstract] [Full Text] [PDF]