Liver cancer · 2024
Particle Therapy for Intrahepatic Cholangiocarcinoma: A Multicenter Prospective Registry Study, Systematic Review and Meta-Analysis.
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Mizumoto Masashi, Shibuya Kei, Terashima Kazuki, Murakami Masao, Murakami Motohiro, Shioyama Yoshiyuki, Matsuo Yoshiro, Ogino Takashi, Ohno Tatsuya, Waki Takahiro, Ogino Hiroyuki, Tamamura Hiroyasu, Katoh Norio, Wakatsuki Masaru, Okimoto Tomoaki, Suzuki Motohisa, Saito Takashi, Toyama Shingo, Hashimoto Takayuki, Ohba Hisateru, Kubo Shoji, Hasegawa Kiyoshi, Maruo Kazushi, Sakurai Hideyuki
Аннотация
INTRODUCTION: A prospective study was started in May 2016 to evaluate the efficacy and safety of particle therapy for intrahepatic cholangial carcinoma (ICC). To compare treatment modalities, we also conducted a meta-analysis of literature data and a systematic comparison using registry data.
METHODS: Patients who received particle therapy for ICC from May 2016 to June 2018 were registered. Nineteen manuscripts (4 particle therapy, 8 3D-CRT, 7 SBRT) were selected for the meta-analysis.
RESULTS: A total of 85 cases (proton beam therapy 59, carbon therapy 26) were registered. The median overall survival (OS) of the 85 patients was 22.1 months (95% CI: 12.9-31.3); the 1-, 2-, 3-, and 4-year OS rates were 70.9% (95% CI: 61.1-80.7%), 47.6% (36.8-58.4%), 37.7% (26.7-48.7%), and 22.7% (10.2-35.2%), respectively; and the 1-, 2-, 3-, and 4-year local recurrence rates were 8.2% (1.1-15.3%), 21.6% (9.3-33.9%), 33.4% (16.7-50.1%), and 33.4% (16.7-50.1%), respectively. In the meta-analysis and registry data, the 1-year OS for particle therapy, SBRT and 3D-CRT were 71.8% (95% CI: 64.6-77.8%), 59.2% (53.0-64.9%, p = 0.0573), and 47.2% (36.8-56.9%, p = 0.0004), respectively. The incidence of grade 3 or higher late non-hematological toxicity in the meta-analysis and registry data were 7.4-12% for particle therapy, 6.7-16.7% for SBRT, and 8.1-14.3% for 3D-CRT.
CONCLUSIONS: Particle therapy achieved a good therapeutic effect for ICC, and a meta-analysis indicated that particle therapy is a better treatment modality than SBRT and 3D-CRT.
METHODS: Patients who received particle therapy for ICC from May 2016 to June 2018 were registered. Nineteen manuscripts (4 particle therapy, 8 3D-CRT, 7 SBRT) were selected for the meta-analysis.
RESULTS: A total of 85 cases (proton beam therapy 59, carbon therapy 26) were registered. The median overall survival (OS) of the 85 patients was 22.1 months (95% CI: 12.9-31.3); the 1-, 2-, 3-, and 4-year OS rates were 70.9% (95% CI: 61.1-80.7%), 47.6% (36.8-58.4%), 37.7% (26.7-48.7%), and 22.7% (10.2-35.2%), respectively; and the 1-, 2-, 3-, and 4-year local recurrence rates were 8.2% (1.1-15.3%), 21.6% (9.3-33.9%), 33.4% (16.7-50.1%), and 33.4% (16.7-50.1%), respectively. In the meta-analysis and registry data, the 1-year OS for particle therapy, SBRT and 3D-CRT were 71.8% (95% CI: 64.6-77.8%), 59.2% (53.0-64.9%, p = 0.0573), and 47.2% (36.8-56.9%, p = 0.0004), respectively. The incidence of grade 3 or higher late non-hematological toxicity in the meta-analysis and registry data were 7.4-12% for particle therapy, 6.7-16.7% for SBRT, and 8.1-14.3% for 3D-CRT.
CONCLUSIONS: Particle therapy achieved a good therapeutic effect for ICC, and a meta-analysis indicated that particle therapy is a better treatment modality than SBRT and 3D-CRT.