Comparison of Dose Distributions When Using Carbon Ion Radiotherapy Versus Intensity-modulated Radiotherapy for Hepatocellular Carcinoma With Macroscopic Vascular Invasion: A Retrospective Analysis

Abstract Background. Studies comparing the dose distributions of carbon ion radiotherapy (C-ion RT) and intensity-modulated radiotherapy (IMRT) in patients with locally advanced hepatocellular carcinoma (LAHCC) are lacking. This study aimed to investigate the dose distributions of these modalities and identify any advantages to using C-ion RT. Methods. Patients with LAHCC who had undergone C-ion RT between June 2010 and November 2018 were retrospectively analyzed. From among 210 patients with hepatocellular carcinoma who received C-ion RT, 10 consecutive patients with LAHCC were included. The dose-volume histogram parameters of clinical plans using C-ion RT at 60 Gy (relative biological effectiveness [RBE]) and simulated plans using IMRT at 60 Gy and 50 Gy were compared. We evaluated the three plans in terms of the following parameters: the percentage of the minimum dose that covered 95% of the target volume (D95); mean liver dose (MLD); and percentage of the normal liver volume that received at least 5 Gy (V5), 10 Gy (V10), 20 Gy (V20), 30 Gy (V30), 40 Gy, and 50 Gy. Patients at high risk of developing radiation-induced liver disease (RILD) were those with MLD and V30 of >23 Gy and >28%, respectively. Results. The V5, V10, V20, and MLD were significantly lower in patients who received 60 Gy (RBE) of C-ion RT than in those who received 60 Gy of IMRT, although the D95 values were not significantly different. The V5, V10, and V20 were also significantly lower in patients who received 60 Gy (RBE) of C-ion RT than in those who received 50 Gy of IMRT; moreover the D95 was significantly superior in the former group. The numbers of high-risk patients who developed RILD when administered 60 Gy (RBE) of C-ion RT, 60 Gy of IMRT, and 50 Gy of IMRT were 1, 7, and 6, respectively. Conclusions. C-ion RT exhibits a better dose distribution to the liver than does IMRT when treating patients with LAHCC. C-ion RT made it possible to treat patients with LAHCC who otherwise could not be treated using IMRT because of the high risk of RILD.

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Intensity-modulated radiotherapy versus proton radiotherapy versus carbon ion radiotherapy for spinal bone metastases: a treatment planning study

Journal of Applied Clinical Medical Physics ◽

10.1120/jacmp.v16i6.5618 ◽

2015 ◽

Vol 16 (6) ◽

pp. 186-194 ◽

Cited By ~ 4

Author(s):

Harald Rief ◽

Naved Chaudhri ◽

Eric Tonndorf-Martini ◽

Thomas Bruckner ◽

Stefan Rieken ◽

...

Keyword(s):

Bone Metastases ◽

Treatment Planning ◽

Intensity Modulated Radiotherapy ◽

Carbon Ion Radiotherapy ◽

Proton Radiotherapy ◽

Planning Study ◽

Carbon Ion ◽

Intensity Modulated ◽

Spinal Bone Metastases

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Intensity Modulated Radiotherapy with Carbon Ion Radiotherapy Boost for Acinic Cell Carcinoma of the Salivary Glands

Cancers ◽

10.3390/cancers13010124 ◽

2021 ◽

Vol 13 (1) ◽

pp. 124

Author(s):

Maximilian P. Schmid ◽

Thomas Held ◽

Kristin Lang ◽

Klaus Herfarth ◽

Juliane Hörner-Rieber ◽

...

Keyword(s):

Cell Carcinoma ◽

Salivary Glands ◽

Ion Beam ◽

Intensity Modulated Radiotherapy ◽

Acinic Cell Carcinoma ◽

Carbon Ion Radiotherapy ◽

Definitive Treatment ◽

Carbon Ion ◽

Intensity Modulated ◽

Acinic Cell

Aim: to report clinical outcome in patients with acinic cell carcinoma of the salivary glands treated with intensity-modulated radiotherapy (IMRT) and carbon ion radiotherapy (CIRT) boost. Materials and Methods: all patients with acinic cell carcinoma of the salivary glands treated at the Heidelberg Ion-Beam Therapy Center were considered for this retrospective analysis. All patients received a CIRT boost with 18–24 Gy radiobiologic effectiveness (RBE)-weighted dose in 3 Gy RBE-weighted dose per fraction followed by IMRT, with 50–54 Gy in 2 Gy per fraction. Disease outcome was evaluated for local (LR), nodal (NR), distant recurrence (DR), and disease-free (DFS) and overall survival (OS). Morbidity was scored based on Common Terminology Criteria for Adverse Events (CTCAE) version 5. Descriptive statistics and the Kaplan-Meier method were used for analysis. Results: fifteen patients were available for analysis. Median follow-up after radiotherapy was 43 months. Six patients were treated for primary disease and nine for recurrent disease. Eight patients were treated with radiotherapy for macroscopic disease. Disease recurrence was observed in four patients: 1 LR, 2 NR, and 2 DR; 5-year local control, DFS, and OS were 80%, 52%, and 80%, respectively. No radiotherapy-related G3-5 morbidity was observed. Conclusion: In acinic cell carcinoma, IMRT with carbon ion radiotherapy boost leads to excellent results after R1-resection and is a promising treatment modality for definitive treatment in inoperable patients.

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PO-1077: Carbon-ion radiotherapy for hepatocellular carcinoma with vascular invasion

Radiotherapy and Oncology ◽

10.1016/s0167-8140(21)01094-x ◽

2020 ◽

Vol 152 ◽

pp. S570-S571

Author(s):

H. Makishima ◽

S. Yasuda ◽

H. Kato ◽

T. Kaneko ◽

H. Sato ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Vascular Invasion ◽

Carbon Ion Radiotherapy ◽

Carbon Ion

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Combination Therapy after TACE for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: Stereotactic Body Radiotherapy versus Sorafenib

Cancers ◽

10.3390/cancers10120516 ◽

2018 ◽

Vol 10 (12) ◽

pp. 516 ◽

Cited By ~ 2

Author(s):

Lujun Shen ◽

Mian Xi ◽

Lei Zhao ◽

Xuhui Zhang ◽

Xiuchen Wang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Stereotactic Body Radiotherapy ◽

Vascular Invasion ◽

Progression Free Survival ◽

Sorafenib Treatment ◽

Free Survival ◽

Sorafenib Group ◽

Treatment Responses ◽

Hepatic Lesions ◽

Macroscopic Vascular Invasion

Stereotactic body radiotherapy (SBRT) has shown promising results in the control of macroscopic vascular invasion in patients with hepatocellular carcinoma (HCC); however, its efficacy in comparison to sorafenib when combined with transarterial chemoembolization (TACE) remains to be determined. Between 2009 and 2017, 77 HCC patients with macroscopic vascular invasion receiving TACE–SBRT or TACE–sorafenib combination therapies were enrolled. The best treatment responses, overall survival (OS), and progression-free survival (PFS) of the two treatment arms were compared. Of the patients enrolled, 26 patients (33.8%) received TACE–SBRT treatment, and 51 (66.2%) received TACE–sorafenib treatment. The patients in the TACE–SBRT group were more frequently classified as elder in age (p = 0.012), having recurrent disease (p = 0.026), and showing lower rates of multiple hepatic lesions (p = 0.005) than patients in TACE–sorafenib group. After propensity score matching (PSM), 26 pairs of well-matched HCC patients were selected; patients in the TACE–SBRT group showed better overall response rates in trend compared to those in the TACE–sorafenib group. The hazard ratio (HR) of OS to PFS for the TACE–SBRT approach and the TACE–sorafenib approach was 0.36 (95% CI, 0.17–0.75; p = 0.007) and 0.35 (95% CI, 0.20–0.62; p < 0.001), respectively. For HCC patients with macrovascular invasion, TACE plus SBRT could provide improved OS and PFS compared to TACE–sorafenib therapy.

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