A feasibility study of high-dose hypofractionated carbon ion radiation therapy using four fractions for localized hepatocellular carcinoma measuring 3 cm or larger

Radiother Oncol. 2019 Mar:132:230-235. doi: 10.1016/j.radonc.2018.10.009. Epub 2018 Oct 23.

Abstract

Background and purpose: To evaluate the safety of carbon-ion radiotherapy (C-ion RT) using 60 Gy (relative biological effectiveness, RBE) in four fractions for patients with hepatocellular carcinoma (HCC).

Materials and methods: The primary outcome was acute toxicities within 90 days. The secondary outcomes were late toxicities, local control, and progression-free survival and overall survival rates. The key inclusion criteria were as follows: (1) 3 cm or larger HCC without major vascular invasion and not adjacent to the alimentary tract; (2) Child-Pugh's grade A/B; and (3) without extrahepatic metastasis.

Results: A total of 21 cases were analyzed between October 2012 and April 2016. The median follow-up period among the 17 survivors was 24.2 (range: 6.3-43.7) months. Grade 3 or higher acute toxicity was not observed, while three (14.3%) of the 21 patients experienced grade 3 late toxicities. The 1- and 2-year local control, progression-free survival, and overall survival rates were 100% and 92.3%, 81.0% and 50.0%, and 90.5% and 80.0%, respectively.

Conclusion: C-ion RT using 60 Gy (RBE) in four fractions was safe and achieved promising local tumor control.

Keywords: Carbon ion radiotherapy; Hepatocellular carcinoma; Hypofractionation; Radiotherapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / radiotherapy*
  • Feasibility Studies
  • Female
  • Heavy Ion Radiotherapy / methods*
  • Humans
  • Liver Neoplasms / pathology
  • Liver Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Radiation Dose Hypofractionation
  • Radiotherapy Planning, Computer-Assisted
  • Relative Biological Effectiveness
  • Survival Rate