Proton Beam Therapy without Fiducial Markers Using Four-Dimensional CT Planning for Large Hepatocellular Carcinomas
Autor: | Miu Mizuhata, Tomoyasu Kumano, Sayuri Bou, Shigeyuki Takamatsu, Yoshitaka Sato, Kazutaka Yamamoto, Hiroyasu Tamamura, Toshifumi Gabata, Makoto Sasaki, Satoshi Shibata, Satoko Asahi, Satoshi Kobayashi, Yuji Tameshige, Mariko Kawamura, Yoshikazu Maeda |
---|---|
Rok vydání: | 2018 |
Předmět: |
Cancer Research
lcsh:RC254-282 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Patient age hepatocellular carcinoma 4-dimensional CT planning respiratory-gated irradiation proton beam therapy medicine Effective treatment Adverse effect Tumor size Four-Dimensional CT business.industry lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Oncology 030220 oncology & carcinogenesis Hepatocellular carcinoma Total dose Erratum Nuclear medicine business Fiducial marker |
Zdroj: | Cancers; Volume 10; Issue 3; Pages: 71 Cancers Cancers, Vol 10, Iss 3, p 71 (2018) |
ISSN: | 2072-6694 |
DOI: | 10.3390/cancers10030071 |
Popis: | We evaluated the effectiveness and toxicity of proton beam therapy (PBT) for hepatocellular carcinomas (HCC) >5 cm without fiducial markers using four-dimensional CT (4D-CT) planning. The subjects were 29 patients treated at our hospital between March 2011 and March 2015. The median total dose was 76 Cobalt Gray Equivalents (CGE) in 20 fractions (range; 66–80.5 CGE in 10–32 fractions). Therapy was delivered with end-expiratory phase gating. An internal target volume (ITV) margin was added through the analysis of respiratory movement with 4D-CT. Patient age ranged from 38 to 87 years (median, 71 years). Twenty-four patients were Child–Pugh class A and five patients were class B. Tumor size ranged from 5.0 to 13.9 cm (median, 6.9 cm). The follow-up period ranged from 2 to 72 months (median; 27 months). All patients completed PBT according to the treatment protocol without grade 4 (CTCAE v4.03 (draft v5.0)) or higher adverse effects. The two-year local tumor control (LTC), progression-free survival (PFS), and overall survival (OS) rates were 95%, 22%, and 61%, respectively. The LTC was not inferior to that of previous reports using fiducial markers. Respiratory-gated PBT with 4D-CT planning without fiducial markers is a less invasive and equally effective treatment for large HCCs as PBT with fiducial markers. |
Databáze: | OpenAIRE |
Externí odkaz: | |
Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |