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Cancers 2018, 10(2), 58; https://doi.org/10.3390/cancers10020058

Respiratory-Gated Proton Beam Therapy for Hepatocellular Carcinoma Adjacent to the Gastrointestinal Tract without Fiducial Markers

1
Proton Therapy Center, Fukui Prefectural Hospital, Fukui city, Fukui 910-8526, Japan
2
Department of Radiotherapy, Kanazawa University Hospital, Kanazawa city, Ishikawa 920-8641, Japan
3
Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya city, Aichi 466-8560, Japan
4
Department of Radiology, University of Fukui, Fukui City 910-1193, Fukui, Japan
5
Department of Radiology, Kanazawa University, Kanazawa City, Ishikawa 920-8641, Japan
*
Author to whom correspondence should be addressed.
Received: 29 January 2018 / Revised: 16 February 2018 / Accepted: 19 February 2018 / Published: 21 February 2018
(This article belongs to the Special Issue Proton and Carbon Ion Therapy)
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Abstract

The efficacy of proton beam therapy (PBT) for hepatocellular carcinoma (HCC) has been reported, but insertion of fiducial markers in the liver is usually required. We evaluated the efficacy and toxicity of respiratory-gated PBT without fiducial markers for HCC located within 2 cm of the gastrointestinal tract. From March 2011 to December 2015 at our institution, 40 patients were evaluated (median age, 72 years; range, 38–87 years). All patients underwent PBT at a dose of 60 to 80 cobalt gray equivalents (CGE) in 20 to 38 fractions. The median follow-up period was 19.9 months (range, 1.2–72.3 months). The median tumor size was 36.5 mm (range, 11–124 mm). Kaplan–Meier estimates of the 2-year overall survival, progression-free survival, and local tumor control rates were 76%, 60%, and 94%, respectively. One patient (2.5%) developed a grade 3 gastric ulcer and one (2.5%) developed grade 3 ascites retention; none of the remaining patients developed grade >3 toxicities (National Cancer Institute Common Terminology Criteria for Adverse Events ver. 4.0.). This study indicates that PBT without fiducial markers achieves good local control without severe treatment-related toxicity of the gastrointestinal tract for HCC located within 2 cm of the gastrointestinal tract. View Full-Text
Keywords: proton beam therapy; hepatocellular carcinoma; 4D-CT; gastrointestinal tract; respiratory-gated irradiation proton beam therapy; hepatocellular carcinoma; 4D-CT; gastrointestinal tract; respiratory-gated irradiation
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Mizuhata, M.; Takamatsu, S.; Shibata, S.; Bou, S.; Sato, Y.; Kawamura, M.; Asahi, S.; Tameshige, Y.; Maeda, Y.; Sasaki, M.; Kumano, T.; Kobayashi, S.; Yamamoto, K.; Tamamura, H.; Gabata, T. Respiratory-Gated Proton Beam Therapy for Hepatocellular Carcinoma Adjacent to the Gastrointestinal Tract without Fiducial Markers. Cancers 2018, 10, 58.

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