Proton Beam Therapy without Fiducial Markers Using Four-Dimensional CT Planning for Large Hepatocellular Carcinomas
AbstractWe evaluated the effectiveness and toxicity of proton beam therapy (PBT) for hepatocellular carcinomas (HCC) >5 cm without fiducial markers using four-dimensional CT (4D-CT) planning. The subjects were 29 patients treated at our hospital between March 2011 and March 2015. The median total dose was 76 Cobalt Gray Equivalents (CGE) in 20 fractions (range; 66–80.5 CGE in 10–32 fractions). Therapy was delivered with end-expiratory phase gating. An internal target volume (ITV) margin was added through the analysis of respiratory movement with 4D-CT. Patient age ranged from 38 to 87 years (median, 71 years). Twenty-four patients were Child–Pugh class A and five patients were class B. Tumor size ranged from 5.0 to 13.9 cm (median, 6.9 cm). The follow-up period ranged from 2 to 72 months (median; 27 months). All patients completed PBT according to the treatment protocol without grade 4 (CTCAE v4.03 (draft v5.0)) or higher adverse effects. The two-year local tumor control (LTC), progression-free survival (PFS), and overall survival (OS) rates were 95%, 22%, and 61%, respectively. The LTC was not inferior to that of previous reports using fiducial markers. Respiratory-gated PBT with 4D-CT planning without fiducial markers is a less invasive and equally effective treatment for large HCCs as PBT with fiducial markers. View Full-Text
Share & Cite This Article
Shibata, S.; Takamatsu, S.; Yamamoto, K.; Mizuhata, M.; Bou, S.; Sato, Y.; Kawamura, M.; Asahi, S.; Tameshige, Y.; Maeda, Y.; Sasaki, M.; Kumano, T.; Kobayashi, S.; Tamamura, H.; Gabata, T. Proton Beam Therapy without Fiducial Markers Using Four-Dimensional CT Planning for Large Hepatocellular Carcinomas. Cancers 2018, 10, 71.
Shibata S, Takamatsu S, Yamamoto K, Mizuhata M, Bou S, Sato Y, Kawamura M, Asahi S, Tameshige Y, Maeda Y, Sasaki M, Kumano T, Kobayashi S, Tamamura H, Gabata T. Proton Beam Therapy without Fiducial Markers Using Four-Dimensional CT Planning for Large Hepatocellular Carcinomas. Cancers. 2018; 10(3):71.Chicago/Turabian Style
Shibata, Satoshi; Takamatsu, Shigeyuki; Yamamoto, Kazutaka; Mizuhata, Miu; Bou, Sayuri; Sato, Yoshitaka; Kawamura, Mariko; Asahi, Satoko; Tameshige, Yuji; Maeda, Yoshikazu; Sasaki, Makoto; Kumano, Tomoyasu; Kobayashi, Satoshi; Tamamura, Hiroyasu; Gabata, Toshifumi. 2018. "Proton Beam Therapy without Fiducial Markers Using Four-Dimensional CT Planning for Large Hepatocellular Carcinomas." Cancers 10, no. 3: 71.
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.