Phase I Dose-Escalation Study of Proton Beam Therapy for Inoperable Hepatocellular Carcinoma.
- Author:
Tae Hyun KIM
1
;
Joong Won PARK
;
Yeon Joo KIM
;
Bo Hyun KIM
;
Sang Myung WOO
;
Sung Ho MOON
;
Sang Soo KIM
;
Young Hwan KOH
;
Woo Jin LEE
;
Sang Jae PARK
;
Joo Young KIM
;
Dae Yong KIM
;
Chang Min KIM
Author Information
- Publication Type:Original Article
- Keywords: Hepatocellular carcinoma; Proton therapy; Radiotherapy
- MeSH: Carcinoma, Hepatocellular*; Disease-Free Survival; Humans; Liver Transplantation; Neoplasm, Residual; Proton Therapy*; Radiotherapy; Survival Rate
- From:Cancer Research and Treatment 2015;47(1):34-45
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The purpose of this study is to determine the optimal dose of proton beam therapy (PBT) in hepatocellular carcinoma (HCC) patients. MATERIALS AND METHODS: Inoperable HCC patients who had naive, recurrent, or residual tumor to treatment were considered eligible for PBT. Patients received PBT with 60 GyE in 20 fractions (dose level 1; equivalent dose in 2 Gy fractions [EQD2], 65 GyE10); 66 GyE in 22 fractions (dose level 2; EQD2, 71.5 GyE10); or 72 GyE in 24 fractions (dose level 3; EQD2, 78 GyE10). Dose-limiting toxicity was determined by grade > or = 3 acute toxicity. RESULTS: Twenty-seven patients were enrolled; eight, seven, and 12 patients were treated with dose levels 1, 2, and 3, respectively. Overall, treatment was well tolerated, with no dose-limiting toxicities. The complete response (CR) rates of primary tumors after PBT for dose levels 1, 2, and 3 were 62.5% (5/8), 57.1% (4/7), and 100% (12/12), respectively (p=0.039). The 3-and 5-year local progression-free survival (LPFS) rates among 26 patients, excluding one patient who underwent liver transplantation after PBT due to its probable significant effect on disease control, were 79.9% and 63.9%, respectively, and the 3-and 5-year overall survival rates were 56.4% and 42.3%, respectively. The 3-year LPFS rate was significantly higher in patients who achieved CR than in those who did not (90% vs. 40%, p=0.003). CONCLUSION: PBT is safe and effective and an EQD2 > or = 78 GyE10 should be delivered for achievement of local tumor control.
