Establishment of proton beam therapy for hepatocellular carcinoma

肝细胞癌质子束治疗的建立

• 批准号: 06670518
• 负责人: MATSUZAKI Yasushi
• 金额: $ 1.28万
• 依托单位: University of Tsukuba
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1994
• 资助国家: 日本
• 起止时间: 1994 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-06670518/
• 关键词: Proton beam; Bragg-peak; Hepatocellular carcinoma; Liver cirrhosis; QOL; 局所制御; 集学的治療; 陽子線照射療法; 選択的照射

We here report the long-term (4years) effects of proton irradiation for HCC,in comparison with that of Lipiodol-targeted chemotherapy (1-TAI), in order to clarify the role of this new therapy for the treatment of HCC.[Materials and Methods] Informed consent was obtained from 48 HCC patients. 75 HCC lesions in the 48 patients which were treated with either proton irradiation alone (Mono : 46 lesions) or with Lipiodol-targeted chemotherapy (1-TAI) plus proton irradiation (Combi : 29 lesions) were included in the analysis. Proton beam was provided by the cynclotoron of the National Laboratory for High Energy Physics (KEK). Total amount of 75 Gy (mean) of the proton beam was targeted to HCC,which ranged from 1 to 12cm in size. The results from these patients were compared with those from 42 patients (65 HCC lesions) treated with 1-TAI alone (1-TAI group), whose background did not differ from the proton groups. All tumor was followed up by CAT scan and ultrasonography. [Results] 1) : After … More 1 yr, the reduction of tumor size was observed in 40 out of 46 lesions (87%) in Mono, 21 out of 29 lesions (72%) in Combi, compared with 30 of 65 lesions (46%) in 1-TAI group. After 2 yrs, size reduction was seen in 11 of 12 (92%) in Mono, 10 of 10 (100%) in Combi and 10 of 16 (63%) in 1-TAI group. After 4 yrs, size reduction was seen in 1 of 1 (100%) in Mono, 3 of 3 (100%) in Combi and 2 of 3 (67%) in 1-TAI group. 2) : Local tumor control rate (no local recurrence) was significantly higher in the proton groups (Mono and Combi) than in the 1-TAI group. By Kaplan and Meier's methods, cumulative local tumor control rates, at the end of 1st yr : 97% for both Mono and Combi, 70% for 1-TAI group, at the end of 4th yr : 60% for Mono, 90% for Combi, 30% for 1-TAI.3) : Survival rate was also significantly higher in the proton groups than in the 1-TAI group during follow-up period. Cumulative survival rates at the end of 2nd and 4th yrs, were 87%, 74% for the proton groups, and 74%, 45% for the 1-TAI group, respectively. 4) : Excellent QOL was maintained in all cases treated with proton therapy during observation period. [Conclusion] HCC patients treated with proton irradiation showed more excellent local tumor control as well as better survival and QOL,in comparison with 1-TAI,which lasted for at least 4 yrs. This therapy is safe and has a special merit of excellent QOL during the treatment without any complaints. Advantages of this methods are the availability for deep-seated tumor, patient with serious complications. Less

我们在此报告了质子照射治疗HCC的长期（4年）效果，并与脂醇靶向化疗（1-TAI）进行了比较，以阐明这种新疗法在HCC治疗中的作用。【材料与方法】48例HCC患者获得知情同意。在48例HCC患者中，75个HCC病变包括单独质子照射（Mono: 46个病变）或脂醇靶向化疗（1-TAI）加质子照射（Combi: 29个病变）。质子束由国家高能物理实验室（KEK）的回旋加速器提供。质子束的总剂量为75 Gy（平均），靶向HCC，大小从1到12cm不等。这些患者的结果与单独接受1-TAI治疗的42例患者（65例HCC病变）（1-TAI组）的结果进行比较，这些患者的背景与质子组没有差异。所有肿瘤均行CAT扫描和超声检查。[结果]1):1年多后，Mono组46个病变中有40个（87%）肿瘤缩小，Combi组29个病变中有21个（72%）肿瘤缩小，而1- tai组65个病变中有30个（46%）肿瘤缩小。2年后，Mono组12例患者中有11例（92%）缩小，Combi组10例（100%）缩小，1-TAI组16例中有10例（63%）缩小。4年后，Mono组1例（100%）、Combi组3例（100%）和1- tai组3例（67%）患者的体积减小。2)：质子组（Mono和Combi）的局部肿瘤控制率（无局部复发）明显高于1-TAI组。通过Kaplan和Meier的方法，1年底累积局部肿瘤控制率：Mono和Combi组均为97%，1-TAI组为70%，第4年底：Mono组为60%，Combi组为90%，1-TAI组为30%。3)：随访期间质子组的生存率也显著高于1-TAI组。质子组2年和4年的累积生存率分别为87%和74%，1-TAI组为74%和45%。4)：观察期内所有质子治疗病例均保持良好的生活质量。【结论】与1-TAI相比，质子照射治疗HCC患者的局部肿瘤控制更出色，生存期和生活质量也更好，持续时间至少为4年。该疗法安全可靠，治疗过程中生活质量好，无任何不适。该方法的优点是可用于深部肿瘤，患者并发症严重。少

项目成果

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