PROTON BEAM THERAPY FOR HEPATOCELLULAR CARCINOMA: A COMPARISON OF THREE TREATMENT PROTOCOLS
PROTON BEAM THERAPY FOR HEPATOCELLULAR CARCINOMA: A COMPARISON OF THREE TREATMENT PROTOCOLS
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DOI：
10.1016/j.ijrobp.2010.07.015
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发表时间：
2011-11-15
影响因子：
7
通讯作者：
Sakurai, Hideyuki
中科院分区：
文献类型：
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作者：
Mizumoto, Masashi;Okumura, Toshiyuki;Sakurai, Hideyuki
背景资料：我们先前的结果显示，质子束治疗肝癌（HCC）具有良好的局部控制和低毒性。三种方案用于避免晚期并发症，如胃肠道溃疡和胆管狭窄。在这项研究中，我们研究了这些protocols.Methods和材料的疗效：受试者是266例（273肝癌）质子束治疗在筑波大学2001年1月至2007年12月。三个治疗方案（A，66 GyE在10个分数; B，72.6 GyE在22个分数;和C，77 GyE在35个分数）被使用，这取决于肿瘤location.Results：在266例患者中，104，95，和60例患者分别与方案A，B，和C。7例双病灶患者接受了两种不同的方案。1、3和5年后的总生存率分别为87%、61%和48%（中位生存期为4.2年）。多变量分析显示，肝功能较好、临床靶体积较小、既往未接受治疗（照射野外）与良好的生存率相关。1年、3年和5年后的局部控制率分别为98%、87%和81%。多变量分析没有发现任何因素与良好的局部control.Conclusions：这项研究表明，质子束治疗实现了良好的局部控制肝癌使用的三种治疗方案。这表明，基于肿瘤位置选择治疗方案可用于降低晚期毒性的风险并保持良好的治疗效果。(C)2011 Elsevier Inc.
Background: Our previous results for treatment of hepatocellular carcinoma (HCC) with proton beam therapy revealed excellent local control with low toxicity. Three protocols were used to avoid late complications such as gastrointestinal ulceration and bile duct stenosis. In this study, we examined the efficacy of these protocols.Methods and Materials: The subjects were 266 patients (273 HCCs) treated by proton beam therapy at the University of Tsukuba between January 2001 and December 2007. Three treatment protocols (A, 66 GyE in 10 fractions; B, 72.6 GyE in 22 fractions; and C, 77 GyE in 35 fractions) were used, depending on the tumor location.Results: Of the 266 patients, 104, 95, and 60 patients were treated with protocols A, B, and C, respectively. Seven patients with double lesions underwent two different protocols. The overall survival rates after 1, 3 and 5 years were 87%, 61%, and 48%, respectively (median survival, 4.2 years). Multivariate analysis showed that better liver function, small clinical target volume, and no prior treatment (outside the irradiated field) were associated with good survival. The local control rates after 1, 3, and 5 years were 98%, 87%, and 81%, respectively. Multivariate analysis did not identify any factors associated with good local control.Conclusions: This study showed that proton beam therapy achieved good local control for HCC using each of three treatment protocols. This suggests that selection of treatment schedules based on tumor location may be used to reduce the risk of late toxicity and maintain good treatment efficacy. (C) 2011 Elsevier Inc.