Proton Beam Therapy for Hepatocellular Carcinoma The University of Tsukuba Experience
Proton Beam Therapy for Hepatocellular Carcinoma The University of Tsukuba Experience
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DOI：
10.1002/cncr.24619
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发表时间：
2009-12-01
期刊：
影响因子：
6.2
通讯作者：
Tokuuye, Koichi
中科院分区：
文献类型：
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作者：
Nakayama, Hidetsugu;Sugahara, Shinji;Tokuuye, Koichi
背景技术背景：作者发表了一系列研究，评价质子束治疗在各种临床环境中治疗肝细胞癌的安全性和有效性。在目前的研究中，他们回顾性地回顾了他们在筑波大学的医院设施中使用质子束治疗肝细胞癌患者的整个经验。方法：从2001年11月至2007年12月，333例肝细胞癌患者在筑波大学接受了质子束治疗。本研究共纳入318例患者。递送的总剂量和分次方案通过基于肿瘤位置而变化的方案来确定。评估生存率和预后因素。研究结果：1年、3年和5年的总体精算生存率分别为89.5%（95%置信区间[95% CI]，85.7-93.1%）、64.7%（95% CI，56.6-72.9%）和44.6%（95% CI，29.7-59.5%）。Child-Pugh肝功能（风险比[HR]，2.84; P <0.01）、T分期（HR，1.94; P <0.05）、体力状态（HR，2.12; P <0.01）和计划靶体积（HR，2.12; P <0.05）显著影响生存率。3年、5年生存率为69.1%（95% CI，59.9-78.3%）和55.9%（95% CI，41.5-70.3%），Child-Pugh A级疾病患者和51.9% Child-Pugh B疾病患者的平均生存率分别为44.5%（95% CI，32.3-71.5%）和44.5%（95% CI，23.1-65.8%）。Child-Pugh A级患者的精算生存率在计划靶体积125 mL组之间存在统计学差异（P <0.05）。结论：作者已经证明质子束治疗对于肝细胞癌患者是安全有效的。他们强烈建议在其他治疗选择有风险或禁忌的患者中考虑质子束治疗。Cancer 2009;115：5499-506. (C)2009年美国癌症协会。
BACKGROUND: The authors have published a series of studies evaluating the safety and efficacy of proton beam therapy for the treatment of hepatocellular carcinoma in a variety of clinical settings. In the current study, they retrospectively reviewed their entire experience treating hepatocellular carcinoma patients with proton beam therapy at their hospital-based facility at the University of Tsukuba. METHODS: From November 2001 to December 2007, 333 patients with hepatocellular carcinoma were treated with proton beam therapy at the University of Tsukuba. A total of 318 patients were included in this study. Total dose delivered and fractionation scheme were determined by protocols that varied based on location of tumor. Survival rates and prognostic factors were assessed. RESULTS: Overall actuarial survival rates at 1-year, 3-years, and 5-years were 89.5% (95% confidence interval [95% CI], 85.7-93.1%), 64.7% (95% Cl, 56.6-72.9%), and 44.6% (95% Cl, 29.7-59.5%), respectively. Child-Pugh liver function (hazards ratio [HR], 2.84; P < .01), T stage (HR, 1,94; P < .05), performance status (HR, 2.12; P < .01), and planning target volume (HR, 2.12; P < .05) significantly impacted survival. The 3-year and 5-year survival rates were 69.1% (95% Cl, 59.9-78.3%) and 55.9% (95% Cl, 41.5-70.3%), respectively, for patients with Child-Pugh A disease and 51.9% (95% Cl, 32.3-71.5%) and 44.5% (95% Cl, 23.1-65.8%), respectively, for patients with Child-Pugh B disease. The actuarial survival rates of patients with Child-Pugh class A were statistically different between groups of planned target volume 125 mL (P < .05). CONCLUSIONS: The authors have shown proton beam therapy to be both safe and effective for the treatment of patients with hepatocellular carcinoma. They strongly recommend the consideration of proton beam therapy in patients for whom other treatment options are risky or contraindicated. Cancer 2009;115:5499-506. (C) 2009 American Cancer Society.