Clinical Results and Risk Factors of Proton and Carbon Ion Therapy for Hepatocellular Carcinoma
Clinical Results and Risk Factors of Proton and Carbon Ion Therapy for Hepatocellular Carcinoma
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DOI：
10.1002/cncr.26134
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发表时间：
2011-11-01
期刊：
影响因子：
6.2
通讯作者：
Murakami, Masao
中科院分区：
文献类型：
--
作者：
Komatsu, Shohei;Fukumoto, Takumi;Murakami, Masao
背景：本研究的目的是评价质子和碳离子治疗肝细胞癌（HCC）的临床结果。方法：总共有343名连续患者，386个肿瘤，包括242名患者（278例肿瘤）接受质子治疗，101例患者（108个肿瘤）接受碳离子治疗，接受了8种不同的质子治疗方案（52.8-84.0灰色当量[GyE]，4-38个部分）和4种不同的碳离子治疗方案（52.8-76.0 GyE，4-20个部分）。结果：所有患者的5年局部控制率和总生存率分别为90.8%和38.2%。质子和碳离子治疗的5年局部控制率分别为90.2%和93%，5年总生存率分别为38%和36.3%。两种疗法之间的这些发生率没有显着差异。单变量分析确定肿瘤大小是质子治疗、碳离子治疗和所有患者局部复发的独立危险因素。多变量分析确定肿瘤大小是质子治疗和所有患者局部复发的唯一独立危险因素。根据单变量和多变量分析，Child-Pugh分级是质子治疗、碳离子治疗和所有患者总生存率的唯一独立风险因素。无患者死于治疗相关毒性。结论：质子和碳离子治疗HCC在局部控制率和总生存率方面具有可比性。这些疗法可能是传统HCC局部疗法的创新替代方案。Cancer 2011; 117：4890-904. (C)2011年美国癌症协会
BACKGROUND: The objective of this study was to evaluate the clinical outcome of proton and carbon ion therapy for hepatocellular carcinoma (HCC). METHODS: In total, 343 consecutive patients with 386 tumors, including 242 patients (with 278 tumors) who received proton therapy and 101 patients (with 108 tumors) who received carbon ion therapy, were treated on 8 different protocols of proton therapy (52.8-84.0 gray equivalents [GyE] in 4-38 fractions) and on 4 different protocols of carbon ion therapy (52.8-76.0 GyE in 4-20 fractions). RESULTS: The 5-year local control and overall survival rates for all patients were 90.8% and 38.2%, respectively. Regarding proton and carbon ion therapy, the 5-year local control rates were 90.2% and 93%, respectively, and the 5-year overall survival rates were 38% and 36.3%, respectively. These rates did not differ significantly between the 2 therapies. Univariate analysis identified tumor size as an independent risk factor for local recurrence in proton therapy, carbon ion therapy, and in all patients. Multivariate analysis identified tumor size as the only independent risk factor for local recurrence in proton therapy and in all patients. Child-Pugh classification was the only independent risk factor for overall survival in proton therapy, in carbon ion therapy, and in all patients according to both univariate and multivariate analyses. No patients died of treatment-related toxicities. CONCLUSIONS: Proton and carbon ion therapies for HCC were comparable in terms of local control and overall survival rates. These therapies may represent innovative alternatives to conventional local therapies for HCC. Cancer 2011; 117: 4890-904. (C) 2011 American Cancer Society.