scholarly journals Do Biliary Complications after Proton Beam Therapy for Perihilar Hepatocellular Carcinoma Matter?

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2395
Author(s):  
Gyu Sang Yoo ◽  
Jeong Il Yu ◽  
Hee Chul Park ◽  
Dongho Hyun ◽  
Woo Kyoung Jeong ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Proton Beam ◽  
Baseline Level ◽  
Proton Beam Therapy ◽  
Biliary Complications ◽  
Independent Factor ◽  
Biological Effective Dose ◽  
Significant Elevation ◽  
The Right ◽  
Low Rate

We aimed to evaluate the biliary complications and efficacy of proton beam therapy (PBT) for hepatocellular carcinoma (HCC). We retrospectively analyzed 167 patients who received PBT with ≥ 75 GyRBE of biological effective dose with ?/β = 10 for primary HCC. The perihilar region was defined as a 1-cm area extending from the right, left, and common hepatic ducts, including the gallbladder and cystic duct. PBT-related biliary complications were defined as follows: significant elevation in bilirubin level to > 3.0 mg/dL; elevation to more than twice of the baseline level after the completion of PBT; or newly developed radiological biliary abnormalities, which were not caused by HCC progression, comorbidities, or other treatments. Eighty (47.9%) had perihilar HCC. PBT-related events occurred in seven (4.2%), three of whom had perihilar HCC. Radiologic biliary abnormalities developed in 12 patients (7.2%); however, no events were PBT-related. All patients who experienced PBT-related biliary complications had underlying liver cirrhosis. The albumin-bilirubin grade was identified as an independent factor associated with PBT-related biliary complications. PBT at the current dose showed a low rate of PBT-related biliary complications even for patients with perihilar HCC. PBT for HCC patients with risk factors requires attention to reduce PBT-related biliary complications.

scholarly journals A validated proton beam therapy patch-field protocol for effective treatment of large hepatocellular carcinoma

2018 ◽  
Vol 59 (5) ◽  
pp. 632-638 ◽  
Author(s):  
Masatoshi Nakamura ◽  
Nobuyoshi Fukumitsu ◽  
Satoshi Kamizawa ◽  
Haruko Numajiri ◽  
Keiko Nemoto Murofushi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Effective Treatment ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Large Hepatocellular Carcinoma

scholarly journals Transitions of Liver and Biliary Enzymes during Proton Beam Therapy for Hepatocellular Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1840
Author(s):  
Taisuke Sumiya ◽  
Masashi Mizumoto ◽  
Yoshiko Oshiro ◽  
Keiichiro Baba ◽  
Motohiro Murakami ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Proton Beam ◽  
Liver Damage ◽  
Bragg Peak ◽  
Total Bilirubin ◽  
Normal Liver ◽  
Proton Beam Therapy ◽  
Gamma Glutamyl Transpeptidase ◽  
Preserve Liver Function ◽  
Glutamyl Transpeptidase

Proton beam therapy (PBT) is a curative treatment for hepatocellular carcinoma (HCC), because it can preserve liver function due to dose targeting via the Bragg peak. However, the degree of direct liver damage by PBT is unclear. In this study, we retrospectively analyzed liver/biliary enzymes and total bilirubin (T-Bil) as markers of direct liver damage during and early after PBT in 300 patients. The levels of these enzymes and bilirubin were almost stable throughout the treatment period. In patients with normal pretreatment levels, aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), and T-Bil were abnormally elevated in only 2 (1.2%), 1 (0.4%), 0, 2 (1.2%), and 8 (3.5%) patients, respectively, and in 8 of these 13 patients (61.5%) the elevations were temporary. In patients with abnormal pretreatment levels, the levels tended to decrease during PBT. GGT and T-Bil were elevated by 1.62 and 1.57 times in patients who received 66 Gy (RBE) in 10 fractions and 74 Gy (RBE) in 37 fractions, respectively, but again these changes were temporary. These results suggest that direct damage to normal liver caused by PBT is minimal, even if a patient has abnormal pretreatment enzyme levels.

scholarly journals PO-0704: Proton beam therapy for hepatocellular carcinoma with extensive portal vein tumor thrombosis

2015 ◽  
Vol 115 ◽  
pp. S346
Author(s):  
T. Okumura ◽  
N. Fukumitsu ◽  
M. Mizumoto ◽  
H. Ishikawa ◽  
K. Ohnishi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis

The comparisons of the outcomes between surgical resection and proton beam therapy for single primary hepatocellular carcinoma.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 482-482
Author(s):  
Shunsuke Tamura ◽  
Yukiyasu Okamura ◽  
Teiichi Sugiura ◽  
Takaaki Ito ◽  
Yusuke Yamamoto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Proton Beam ◽  
Surgical Resection ◽  
Performance Status ◽  
Proton Beam Therapy ◽  
Primary Hepatocellular Carcinoma ◽  
Free Survival ◽  
Significant Difference ◽  
Clinical Trial Information ◽  
Better Than

482 Background: There are many treatment choices for hepatocellular carcinoma (HCC). Proton beam therapy (PBT) is considered a treatment option for HCC. The purpose of this study was to compare surgical resection (SR) and PBT in order to clarify the prognostic factors for operable HCC based on a single institution’s database. Methods: Patients with single primary nodular HCC ≤ 100 mm without vessel invasion on pretreatment imaging were divided into the SR group and PBT group. In the PBT group, the patients with unresectable HCC due to their liver function and/or performance status (PS) were excluded. Results: There were 314 and 31 patients who underwent SR and PBT, respectively. The median survival time in the SR group was significantly better than in the PBT group (104.1 vs. 64.6 months, p = 0.008). Regarding the relapse-free survival (RFS), there was no significant difference between the SR and PBT groups (33.8 vs. 14.0 months, p = 0.099). Conclusions: In RFS, the PBT group and the SR group were comparable. However, the PBT group was significantly worse than SR group in overall survival. SR may therefore be favorable as an initial treatment for HCC compared to PBT. Clinical trial information: 1856.

Sign in / Sign up

Export Citation Format

Share Document