Proton beam therapy for hepatocellular carcinoma adjacent to the porta hepatis

Purpose: To evaluate the efficacy and safety of proton beam therapy (PBT) for patients with hepatocellular carcinoma (HCC) located adjacent to the porta hepatis. Methods and Materials: Subjects of the study were 53 patients with HCC located within 2 cm of the main portal vein. All patients had tumor confined to the radiation field with no evidence of metastatic disease. All patients had hepatic function levels of a Child-Pugh score of 10 or less, Eastern Cooperative Oncology Group performance status of 2 or less, and no uncontrolled ascites. Patients underwent PBT of 72.6 GyE in 22 fractions from Sept 2001 to Dec 2004. Results: After 3 years, the actuarial survival rate was 45.1 % and local control rate was 86.0 %. Prognostic factors for survival included Child-Pugh score, number of tumors, and a-fetoprotein levels. No late treatment-related toxicity of Grade 2 or higher was observed. Conclusions: The PBT delivering 72.6 GyE in 22 fractions appears to be effective and safe for HCC adjacent to the porta hepatis. (c) 2008 Elsevier Inc.