Hypofractionated proton beam radiotherapy in patients with unresectable liver tumors: multi-institutional prospective results from the Proton Collaborative Group
| Autor: | Craig W. Stevens, Henry Tsai, Carlos Vargas, Michael Durci, Smith Apisarnthanarax, Peyman Kabolizadeh, William F. Hartsell, Jason K. Molitoris, James J. Urbanic, Jonathan B. Ashman, John Chang, Jacob S Parzen |
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| Rok vydání: | 2020 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
Adult Male medicine.medical_specialty Hepatocellular carcinoma lcsh:R895-920 medicine.medical_treatment Unresectable liver tumors lcsh:RC254-282 030218 nuclear medicine & medical imaging Cholangiocarcinoma 03 medical and health sciences Collaborative group 0302 clinical medicine medicine Humans Dosimetry Radiology Nuclear Medicine and imaging In patient Prospective Studies Proton therapy Intrahepatic Cholangiocarcinoma Aged Aged 80 and over business.industry Research Liver Neoplasms Radiotherapy Dosage Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Radiation therapy Oncology 030220 oncology & carcinogenesis Toxicity Female Radiation Dose Hypofractionation Radiology business |
| Zdroj: | Radiation Oncology (London, England) Radiation Oncology, Vol 15, Iss 1, Pp 1-8 (2020) |
| ISSN: | 1748-717X |
| Popis: | Background Recent advances in radiotherapy techniques have allowed ablative doses to be safely delivered to inoperable liver tumors. In this setting, proton beam radiotherapy (PBT) provides the means to escalate radiation dose to the target volume while sparing the uninvolved liver. This study evaluated the safety and efficacy of hypofractionated PBT for liver tumors, predominantly hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Methods We evaluated the prospective registry of the Proton Collaborative Group for patients undergoing definitive PBT for liver tumors. Demographic, clinicopathologic, toxicity, and dosimetry information were compiled. Results To date, 63 patients have been treated at 9 institutions between 2013 and 2019. Thirty (48%) had HCC and 25 (40%) had ICC. The median dose and biological equivalent dose (BED) delivered was 58.05 GyE (range 32.5–75) and 80.5 GyE (range 53.6–100), respectively. The median mean liver BED was 13.9 GyE. Three (4.8%) patients experienced at least one grade ≥ 3 toxicity. With median follow-up of 5.1 months (range 0.1–40.8), the local control (LC) rate at 1 year was 91.2% for HCC and 90.9% for ICC. The 1-year LC was significantly higher (95.7%) for patients receiving BED greater than 75.2 GyE than for patients receiving BED of 75.2 GyE or lower (84.6%, p = 0.029). The overall survival rate at 1 year was 65.6% for HCC and 81.8% for ICC. Conclusions Hypofractionated PBT results in excellent LC, sparing of the uninvolved liver, and low toxicity, even in the setting of dose-escalation. Higher dose correlates with improved LC, highlighting the importance of PBT especially in patients with recurrent or bulky disease. |
| Databáze: | OpenAIRE |
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