Proton beam therapy for hepatocellular carcinoma with portal vein tumor thrombus

被引:89
作者
Hata, M [1 ]
Tokuuye, K
Sugahara, S
Kagei, K
Igaki, H
Hashimoto, T
Ohara, K
Matsuzaki, Y
Tanaka, N
Akine, Y
机构
[1] Univ Tsukuba, Inst Clin Med, Dept Radiat Oncol, Proton Med Res Ctr, Tsukuba, Ibaraki 3058575, Japan
[2] Univ Tsukuba, Univ Hosp, Dept Radiat Oncol, Tsukuba, Ibaraki 305, Japan
[3] Univ Tsukuba, Univ Hosp, Dept Gastroenterol & Hepatol, Tsukuba, Ibaraki 305, Japan
关键词
hepatocellular carcinoma; portal vein tumor thrombus; proton beam therapy; radiation therapy;
D O I
10.1002/cncr.21237
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. Treatment modalities for patients with hepatocellular carcinoma (HCC) who have portal vein turner thrombus (PVTT) are limited and controversial; furthermore, the prognosis for these patients is extremely poor. The authors conducted a retrospective review to determine the role of proton beam therapy in the treatment of patients who had HCC with PVTT. Methods. Twelve patients with HCC who had tumor thrombus in the main trunk or major branches of the portal vein (clinical T3-T4N0M0) were treated with proton beam therapy. At the time they received proton beam irradiation, patients. ranged in age from 42 years to 80 years (median, 62 years), and their tumors ranged in size from 40 mm to 110 mm (median, 60 mm) in greatest dimension. A total dose of 50-72 gray (Gy) (median, 55 Gy) in 10-22 fractions was delivered to the tumors, including PVTT. Results. All tumors that were treated with proton beam therapy remained controlled at a median follow-up of 2.3 years (range, 0.3-7.3 years). Among 12 patients, 10 patients had new liver tumors outside the irradiated volume 0.1-2.4 years after proton beam therapy, and 3 patients also had distant metastases; consequently, 8 patients died of disease, and 2 patients were salvaged by further therapies. The remaining two patients were alive with no evidence of disease 4.3 years and 6.4 years after proton beam therapy. The progression-free survival rates were 67% at 2 years and 24% at 5 years. The median progression-free survival was 2.3 years. According to the Acute Radiation Morbidity Scoring Criteria (Radiation Therapy Oncology Group), therapy-related toxicity-Grade 3 was not observed. Conclusions. Proton beam therapy for patients with HCC who had PVTT was feasible and effective. It appeared to improve survival and local control significantly for these patients.
引用
收藏
页码:794 / 801
页数:8
相关论文
共 49 条
  • [1] ALLISON DJ, 1985, LANCET, V1, P595
  • [2] Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis - Analysis of 48 cases
    Ando, E
    Tanaka, M
    Yamashita, F
    Kuromatsu, R
    Yutani, S
    Fukumori, K
    Sumie, S
    Yano, Y
    Okuda, K
    Sata, M
    [J]. CANCER, 2002, 95 (03) : 588 - 595
  • [3] ANDO K, 1985, Nippon Acta Radiologica, V45, P531
  • [4] Results of surgical and nonsurgical treatment for small-sized hepatocellular carcinomas: A retrospective and nationwide survey in Japan
    Arii, S
    Yamaoka, Y
    Futagawa, S
    Inoue, K
    Kobayashi, K
    Kojiro, M
    Makuuchi, M
    Nakamura, Y
    Okita, K
    Yamada, R
    [J]. HEPATOLOGY, 2000, 32 (06) : 1224 - 1229
  • [5] Epidemiology of primary liver cancer
    Bosch, FX
    Ribes, J
    Borràs, J
    [J]. SEMINARS IN LIVER DISEASE, 1999, 19 (03) : 271 - 285
  • [6] COOK GC, 1985, Q J MED, V57, P705
  • [7] TOXICITY CRITERIA OF THE RADIATION-THERAPY ONCOLOGY GROUP (RTOG) AND THE EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER (EORTC)
    COX, JD
    STETZ, J
    PAJAK, TF
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1995, 31 (05): : 1341 - 1346
  • [8] Partial irradiation of the liver
    Dawson, LA
    Ten Haken, RK
    Lawrence, TS
    [J]. SEMINARS IN RADIATION ONCOLOGY, 2001, 11 (03) : 240 - 246
  • [9] Del Gaudio M, 2004, HEPATO-GASTROENTEROL, V51, P510
  • [10] DOCI R, 1988, CANCER, V61, P1983, DOI 10.1002/1097-0142(19880515)61:10<1983::AID-CNCR2820611009>3.0.CO