Risk-adapted simultaneous integrated boost-proton beam therapy (SIB-PBT) for advanced hepatocellular carcinoma with tumour vascular thrombosis

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• 作者：Dae Yong Kim¹ ; Joong-Won Park¹ ; Tae Hyun Kim ; ^{k2onco@naver.com} ; Bo Hyun Kim ; Sung Ho Moon ; Sang Soo Kim ; Sang Myung Woo ; Young-Hwan Koh ; Woo Jin Lee ; Chang-Min Kim
• 关键词：Hepatocellular carcinoma ; Tumour vascular thrombosis ; Proton beam therapy
• 刊名：Radiotherapy and Oncology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：122
• 期：1
• 页码：122-129
• 全文大小：851 K
• 卷排序：122

文摘

To evaluate clinical effectiveness and safety of simultaneous integrated boost-proton beam therapy (SIB-PBT) in hepatocellular carcinoma (HCC) patients with tumour vascular thrombosis (TVT).Material and methodsForty-one HCC patients with TVT underwent SIB-PBT using three dose-fractionation schemes: if gross tumour volume <1 cm (n = 27), 1–1.9 cm (n = 7), and ⩾2 cm (n = 7) from gastrointestinal structures, 50 GyE (EQD2, 62.5 GyE10), 60 Gy (EQD2, 80 GyE10), 66 Gy (EQD2, 91.3 GyE10), respectively, in 10 fractions was prescribed to planning target volume 1 (PTV1), and 30 GyE (EQD2, 32.5 GyE10) in 10 fractions was prescribed to PTV2.ResultsOverall, treatment was well tolerated, with no grade toxicity ⩾3. Median overall survival (OS) was 34.4 months and 2-year local progression-free survival (LPFS), relapse free survival (RFS), and OS rates were 88.1%, 25%, and 51.1%, respectively. Patients treated with EQD2 of ⩾80 GyE10 tended to show better TVT response (92.8% vs. 55.5%, p = 0.002) 2-year LPFS (92.9% vs. 82.5%, p = 0.463), RFS (28.8% vs. 19%, p = 0.545), and OS (58.4% vs. 46.8%, p = 0.428) rates than those with EQD2 of <80 GyE10. Multivariate analysis showed that TVT response and Child Pugh classification were independent prognostic factors for OS.ConclusionsSIB-PBT is feasible and promising for HCC patients with TVT.