Proton beam therapy versus stereotactic body radiotherapy for hepatocellular carcinoma: practice patterns, outcomes, and the effect of biologically effective dose escalation
| Autor: | W. Tristam Arscott, Charles B. Simone, Shaakir Hasan, Rodney E. Wegner, Vivek Verma, Stephen Abel, Patrick Webster, Alexander V. Kirichenko |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Practice patterns business.industry Proportional hazards model Stereotactic body radiation therapy medicine.medical_treatment Gastroenterology medicine.disease Effective dose (radiation) 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Oncology 030220 oncology & carcinogenesis Hepatocellular carcinoma Medicine Original Article External beam radiotherapy Radiology business Proton therapy Stereotactic body radiotherapy |
| Zdroj: | Journal of gastrointestinal oncology. 10(5) |
| ISSN: | 2078-6891 |
| Popis: | BACKGROUND: Stereotactic body radiation therapy (SBRT) and proton beam therapy (PBT) generally are safe and effective for non-operative hepatocellular carcinoma (HCC). To date, data comparing the two modalities are limited. We aimed to identify the practice patterns and outcomes of nonsurgical HCC cases treated definitively with either SBRT or PBT. METHODS: We queried the National Cancer Database for T1–2N0 HCC patients receiving PBT or SBRT from 2004 to 2015. Patients were excluded for any treatment other than non-palliative external beam radiotherapy. A multivariable binomial regression model identified patterns of SBRT/PBT use, and propensity-matched multivariable Cox regression assessed correlates of survival. RESULTS: A total of 71 patients received PBT and 918 patients received SBRT (median follow-up 45 months). SBRT was used in 1.8% of nonoperative early stage HCC cases in 2004 and 4.2% of cases in 2015, whereas PBT was used in 0.1–0.2% of cases every year. The median biologically effective dose (BED) for SBRT and PBT was 100 Gy10 and 98 Gy10, respectively (OR =0.70, P=0.17). Factors predictive of receiving PBT included: white race, higher comorbidity score, higher education, metropolitan residence, tumors >5 cm and recent treatment (all P |
| Databáze: | OpenAIRE |
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