Abstract
BackgroundTo evaluate the safety and efficacy of carbon ion radiotherapy (C-ion RT) for 80 years or older patients with hepatocellular carcinoma (HCC).MethodsEligibility criteria of this retrospective study were: 1) HCC confirmed by histology or typical hallmarks of HCC by imaging techniques of four-phase multidetector-row computed tomography or dynamic contrast-enhanced magnetic resonance imaging; 2) no intrahepatic metastasis or distant metastasis; 3) no findings suggesting direct infiltration of the gastrointestinal tract; 4) performance status ≤2 by Eastern Cooperative Oncology Group classification; and 5) Child-Pugh classification A or B. Patients received C-ion RT with 52.8 Gy (RBE) or 60.0 Gy (RBE) in four fractions for usual cases and 60.0 Gy (RBE) in 12 fractions for close-to-gastrointestinal tract cases. Toxicities were classified using the National Cancer Institute’s Common Terminology Criteria for Adverse Events (Version 4.0).ResultsBetween March 2011 and November 2015, 31 patients were treated. The median follow-up period of all patients was 23.2 months (range: 8.4–55.3 months). Median age at the time of registration of C-ion RT was 83 years (range: 80–95 years). Child-Pugh grade A and B were 27 patients and 4 patients, respectively.The 2-year estimated overall survival, local control, and progression-free survival rates were 82.3%, 89.2%, and 51.3%, respectively. No patients had Grade 2 or higher acute toxicities (within 3 months after C-ion RT). One patient experienced progression in Child-Pugh classification from A to B within 3 months after C-ion RT. In late toxicities, Grade 3 encephalopathy was observed in 3 patients, and 2 improved with medication.ConclusionsC-ion RT was effective with minimal toxicities for 80 years or older patients with hepatocellular carcinoma.Trial registrationUMIN000020571: date of registration, 14 January 2016, retrospectively registered.
Highlights
To evaluate the safety and efficacy of carbon ion radiotherapy (C-ion RT) for 80 years or older patients with hepatocellular carcinoma (HCC)
Eligibility criteria were: 1) HCC confirmed by histology or typical hallmarks of HCC using imaging techniques of four-phase multidetector-row computed tomography (CT) or dynamic contrast-enhanced magnetic resonance imaging (MRI); 2) no intrahepatic metastasis or distant metastasis; 3) no findings suggesting direct infiltration of the gastrointestinal tract; 4) performance status (PS) ≤ 2 by Eastern Cooperative Oncology Group classification; and 5) Child-Pugh classification A or B
Seventeen of 31 patients were Barcelona Clinic Liver classification (BCLC) classification stage C. hree patients were due to portal vein invasion, 11 were due to performance status 1–2 and 3 patients were due to portal vein invasion and performance status 1–2
Summary
To evaluate the safety and efficacy of carbon ion radiotherapy (C-ion RT) for 80 years or older patients with hepatocellular carcinoma (HCC). Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third major cause of cancer-related death worldwide [1]. In Japan, until 1990 the majority of HCC deaths were below the age of 69, but. In light of the increased age of HCC patients, there is an urgent need for less-invasive local treatments. Proton therapy and stereotactic body radiotherapy (SBRT) with X-rays have been applied for HCC as less-invasive procedures [6,7,8,9]. Carbon ion radiotherapy (C-ion RT) has been used for HCC because of its excellent dose localization property
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