Anticancer research · 2026
Clinical Outcomes of Proton Beam Therapy for Hepatocellular Carcinoma Adjacent to the Gastrointestinal Tract.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Zhou Yuzheng, Nakamura Masaki, Makita Kenji, Hiroshima Yuichi, Hirata Hidenari, Rachi Toshiya, Baba Hiromi, Wakabayashi Masashi, Ikeda Masafumi, Gotohda Naoto, Zenda Sadamoto
Аннотация
BACKGROUND/AIM: To minimize gastrointestinal (GI) toxicity, our institution implemented a treatment strategy during proton beam therapy (PBT) for hepatocellular carcinoma (HCC) located adjacent to the GI tract, in which the GI tract was excluded from the irradiation field partway through treatment. This study evaluated whether this approach influenced local recurrence (LR).
PATIENTS AND METHODS: We retrospectively evaluated patients with HCC who underwent PBT at our institution between 2008 and 2018. Patients were categorized into two groups: those with tumors adjacent to the GI tract and those without. Cumulative LR rates were compared, and GI toxicities were assessed.
RESULTS: A total of 149 patients were analyzed, with 20 in the GI-adjacent group and 129 in the non-adjacent group. The GI-adjacent group received 72.6-76 Gy [relative biological effectiveness (RBE)] in 20-38 fractions, while the non-adjacent group received 66-76 Gy (RBE) in 10-22 fractions. The median follow-up duration was 42 months (range=1-129 months). The 3-year LR rates were 24.9% [95% confidence interval (CI)=7.2%-48.0%] for the GI-adjacent group and 13.6% (95%CI=7.6%-21.3%) for the non-adjacent group, with no significant difference (Gray's test, p=0.15). Tumor size was significantly associated with LR (hazard ratio=2.921, 95%CI=1.079-7.906, p=0.035). No Grade ≥3 GI toxicities were observed, as defined by the Common Terminology Criteria for Adverse Events version 4.0.
CONCLUSION: Sparing the GI tract during PBT for patients with HCC adjacent to the GI tract has a limited effect on LR.
PATIENTS AND METHODS: We retrospectively evaluated patients with HCC who underwent PBT at our institution between 2008 and 2018. Patients were categorized into two groups: those with tumors adjacent to the GI tract and those without. Cumulative LR rates were compared, and GI toxicities were assessed.
RESULTS: A total of 149 patients were analyzed, with 20 in the GI-adjacent group and 129 in the non-adjacent group. The GI-adjacent group received 72.6-76 Gy [relative biological effectiveness (RBE)] in 20-38 fractions, while the non-adjacent group received 66-76 Gy (RBE) in 10-22 fractions. The median follow-up duration was 42 months (range=1-129 months). The 3-year LR rates were 24.9% [95% confidence interval (CI)=7.2%-48.0%] for the GI-adjacent group and 13.6% (95%CI=7.6%-21.3%) for the non-adjacent group, with no significant difference (Gray's test, p=0.15). Tumor size was significantly associated with LR (hazard ratio=2.921, 95%CI=1.079-7.906, p=0.035). No Grade ≥3 GI toxicities were observed, as defined by the Common Terminology Criteria for Adverse Events version 4.0.
CONCLUSION: Sparing the GI tract during PBT for patients with HCC adjacent to the GI tract has a limited effect on LR.