Short-course carbon ion radiotherapy for patients with hepatocellular carcinoma

Purpose: To evaluate the safety and efficacy of the short-course carbon ion radiotherapy (C-ion RT) of 52.8 GyE in 4 fractions for hepatocellular carcinoma (HCC). Methods: Sixty-nine patients were enrolled. Eligibility criteria were as follows: biopsy-proven HCC; recurrent or residual tumor after other ineffective treatments or no indication for any other treatment; no tumor thrombosis of the portal main branch; no other viable lesion outside the planning target volume; no prior radiotherapy for target tumors; hepatic disorder of Child-Pugh classification A or B; Karnofsky performance status of 60-100; no other active cancer; and digestive tract not in contact with clinical target volume. The total dose delivered was 52.8 GyE in 4 fractions for 1 week. The dose per fraction was 13.2 GyE. Results: No hepatic failure resulting from the therapy and no treatment-related death occurred. In 91% and 90% of patients, the Child-Pugh score did not increase by more than 1 point in the early and late phase, respectively. The 5-year overall survival and local control rates were 31% and 94%, respectively. In patients with suitable stage for hepatic resection, that is, a single lesion of 3 to 5 cm in diameter and Child-Pugh classification A liver function, overall survival rate was 69% at 5 years. Conclusions: In most of patients with HCC, short-course C-ion RT does not reduce liver function. It seems to be a minimally invasive and effective therapy for HCC.第49回粒子線治療世界会