International Journal of Radiation Oncology * Biology * Physics
Volume 76, Issue 2 , Pages 460-466 , 1 February 2010

Proton Beam Therapy for Large Hepatocellular Carcinoma

  • Shinji Sugahara, M.D.

      Affiliations

    • Department of Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • Proton Medical Research Center, University of Tsukuba, Ibaraki, Japan
    • Corresponding Author InformationReprint requests to: Shinji Sugahara, M.D., Department of Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan. Tel: (+81) 298-53-3205; Fax: (+81) 298-53-3205
    • ,
  • Yoshiko Oshiro, M.D.

      Affiliations

    • Department of Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • Proton Medical Research Center, University of Tsukuba, Ibaraki, Japan
    • ,
  • Hidetsugu Nakayama, M.D.

      Affiliations

    • Department of Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • Proton Medical Research Center, University of Tsukuba, Ibaraki, Japan
    • ,
  • Kuniaki Fukuda, M.D.

      Affiliations

    • Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • ,
  • Masashi Mizumoto, M.D.

      Affiliations

    • Department of Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • Proton Medical Research Center, University of Tsukuba, Ibaraki, Japan
    • ,
  • Masato Abei, M.D.

      Affiliations

    • Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • ,
  • Junichi Shoda, M.D.

      Affiliations

    • Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • ,
  • Yasushi Matsuzaki, M.D.

      Affiliations

    • Department of Gastroenterology, Tokyo Medical University Kasumigaura Hospital, Ibaraki, Japan
    • ,
  • Eriko Thono, M.D.

      Affiliations

    • Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • ,
  • Mari Tokita, B.A.

      Affiliations

    • Alpert Medical School of Brown University, Providence, RI
    • ,
  • Koji Tsuboi, M.D.

      Affiliations

    • Department of Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • Proton Medical Research Center, University of Tsukuba, Ibaraki, Japan
    • ,
  • Koichi Tokuuye, M.D.

      Affiliations

    • Department of Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
    • Proton Medical Research Center, University of Tsukuba, Ibaraki, Japan

Received 29 August 2008 ,Revised 6 February 2009 ,Accepted 7 February 2009.

References 

  1. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics. CA Cancer J Clin 2005. 2002;55:74–108
  2. Predictive factors for long term prognosis after partial hepatectomy for patients with hepatocellular carcinoma in Japan. The Liver Cancer Study Group of Japan. Cancer. 1994;74:2772–2780
  3. Vilana R, Bruix J, Bru C, et al. Tumor size determines the efficacy of percutaneous ethanol injection for the treatment of small hepatocellular carcinoma. Hepatology. 1992;16:353–357
  4. Harada T, Matsuo K, Inoue T, et al. Is preoperative hepatic arterial chemoembolization safe and effective for hepatocellular carcinoma?. Ann Surg. 1996;224:4–9
  5. Livraghi T, Bolondi L, Lazzaroni S, et al. Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis. A study on 207 patients. Cancer. 1992;69:925–929
  6. Tanaka K, Nakamura S, Numata K, et al. The long term efficacy of combined transcatheter arterial embolization and percutaneous ethanol injection in the treatment of patients with large hepatocellular carcinoma and cirrhosis. Cancer. 1998;82:78–85
  7. Chia-Hsien Cheng J, Chuang VP, Cheng SH, et al. Unresectable hepatocellular carcinoma treated with radiotherapy and/or chemoembolization. Int J Cancer. 2001;96:243–252
  8. Livraghi T, Goldberg SN, Lazzaroni S, et al. Hepatocellular carcinoma: Radio-frequency ablation of medium and large lesions. Radiology. 2000;214:761–768
  9. Bruix J, Sherman M. Management of hepatocellular carcinoma. Hepatology. 2005;42:1208–1236
  10. Yokoyama I, Todo S, Iwatsuki S, et al. Liver transplantation in the treatment of primary liver cancer. Hepatogastroenterology. 1990;37:188–193
  11. Haug CE, Jenkins RL, Rohrer RJ, et al. Liver transplantation for primary hepatic cancer. Transplantation. 1992;53:376–382
  12. Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol. 2001;35:421–430
  13. Capussotti L, Ferrero A, Vigano L, et al. Liver resection for HCC with cirrhosis: Surgical perspectives out of EASL/AASLD guidelines. Eur J Surg Oncol. 2009;35:11–15
  14. Noguchi T, Kawarada Y, Kitagawa M, et al. Clinicopathologic factors influencing the long-term prognosis following hepatic resection for large hepatocellular carcinoma more than 10 cm in diameter. Semin Oncol. 1997;24(2 Suppl. 6):S6-7–S6-13
  15. Lee NH, Chau GY, Lui WY, et al. Surgical treatment and outcome in patients with a hepatocellular carcinoma greater than 10 cm in diameter. Br J Surg. 1998;85:1654–1657
  16. Poon RT, Fan ST, Wong J. Selection criteria for hepatic resection in patients with large hepatocellular carcinoma larger than 10 cm in diameter. J Am Coll Surg. 2002;194:592–602
  17. Zhou XD, Tang ZY, Ma ZC, et al. Surgery for large primary liver cancer more than 10 cm in diameter. J Cancer Res Clin Oncol. 2003;129:543–548
  18. Liau KH, Ruo L, Shia J, et al. Outcome of partial hepatectomy for large (> 10 cm) hepatocellular carcinoma. Cancer. 2005;104:1948–1955
  19. Pandey D, Lee KH, Wai CT, et al. Long term outcome and prognostic factors for large hepatocellular carcinoma (10 cm or more) after surgical resection. Ann Surg Oncol. 2007;14:2817–2823
  20. Mok KT, Wang BW, Lo GH, et al. Multimodality management of hepatocellular carcinoma larger than 10 cm. J Am Coll Surg. 2003;197:730–738
  21. Hawkins MA, Dawson LA. Radiation therapy for hepatocellular carcinoma: From palliation to cure. Cancer. 2006;106:1653–1663
  22. Hashimoto T, Tokuuye K, Fukumitsu N, et al. Repeated proton beam therapy for hepatocellular carcinoma. Int J Radiat Oncol Biol Phys. 2006;65:196–202
  23. Hata M, Tokuuye K, Sugahara S, et al. Proton beam therapy for hepatocellular carcinoma patients with severe cirrhosis. Strahlenther Onkol. 2006;182:713–720
  24. Hata M, Tokuuye K, Sugahara S, et al. Proton beam therapy for hepatocellular carcinoma with portal vein tumor thrombus. Cancer. 2005;104:794–801
  25. Hata M, Tokuuye K, Sugahara S, et al. Proton irradiation in a single fraction for hepatocellular carcinoma patients with uncontrollable ascites. Technical considerations and results. Strahlenther Onkol. 2007;183:411–416
  26. Hata M, Tokuuye K, Sugahara S, et al. Proton beam therapy for aged patients with hepatocellular carcinoma. Int J Radiat Oncol Biol Phys. 2007;69:805–812
  27. Chiba T, Tokuuye K, Matsuzaki Y, et al. Proton beam therapy for hepatocellular carcinoma: A retrospective review of 162 patients. Clin Cancer Res. 2005;11:3799–3805
  28. Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–655
  29. Tsunashima Y, Sakae T, Shioyama Y, et al. Correlation between the respiratory waveform measured using a respiratory sensor and 3D tumor motion in gated radiotherapy. Int J Radiat Oncol Biol Phys. 2004;60:951–958
  30. Fowler JF. The linear-quadratic formula and progress in fractionated radiotherapy. Br J Radiol. 1989;62:679–694
  31. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31:1341–1346
  32. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;31:457–481
  33. Altman DG. Practical statistics for medical research. 2nd ed.. London: Chapman and Hall; 2004;
  34. Lawrence TS, Robertson JM, Anscher MS, et al. Hepatic toxicity resulting from cancer treatment. Int J Radiat Oncol Biol Phys. 1995;31:1237–1248
  35. Sakurai M, Okamura J, Kuroda C. Transcatheter chemo-embolization effective for treating hepatocellular carcinoma. A histopathologic study. Cancer. 1984;54:387–392
  36. Nakamura H, Tanaka T, Hori S, et al. Transcatheter embolization of hepatocellular carcinoma: Assessment of efficacy in cases of resection following embolization. Radiology. 1983;147:401–405
  37. Takayasu K, Moriyama N, Muramatsu Y, et al. Hepatic arterial embolization for hepatocellular carcinoma. Comparison of CT scans and resected specimens. Radiology. 1984;150:661–665
  38. Sitruk V, Seror O, Grando-Lemaire V, et al. [Percutaneous ablation of hepatocellular carcinoma]. Gastroenterol Clin Biol. 2003;27:381–390
  39. Shiina S, Teratani T, Obi S, et al. A randomized controlled trial of radiofrequency ablation with ethanol injection for small hepatocellular carcinoma. Gastroenterology. 2005;129:122–130
  40. Lin SM, Lin CJ, Lin CC, et al. Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma < or =4 cm. Gastroenterology. 2004;127:1714–1723
  41. Lencioni RA, Allgaier HP, Cioni D, et al. Small hepatocellular carcinoma in cirrhosis: Randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection. Radiology. 2003;228:235–240
  42. Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991;21:109–122
  43. Lawrence TS, Ten Haken RK, Kessler ML, et al. The use of 3-D dose volume analysis to predict radiation hepatitis. Int J Radiat Oncol Biol Phys. 1992;23:781–788
  44. Liang SX, Zhu XD, Lu HJ, et al. Hypofractionated three-dimensional conformal radiation therapy for primary liver carcinoma. Cancer. 2005;103:2181–2188
  45. Dawson LA, McGinn CJ, Normolle D, et al. Escalated focal liver radiation and concurrent hepatic artery fluorodeoxyuridine for unresectable intrahepatic malignancies. J Clin Oncol. 2000;18:2210–2218
  46. Ben-Josef E, Normolle D, Ensminger WD, et al. Phase II trial of high-dose conformal radiation therapy with concurrent hepatic artery floxuridine for unresectable intrahepatic malignancies. J Clin Oncol. 2005;23:8739–8747
  47. Teratani T, Shiina S, Yoshida H, et al. Prediction of recurrence of hepatocellular carcinoma after curative ablation using three tumor markers. Hepatology. 2006;44:1518–1527
  48. Rougier P, Mitry E, Barbare JC, et al. Hepatocellular carcinoma (HCC): An update. Semin Oncol. 2007;34:S12–S20
  49. Zhu AX. Systemic therapy of advanced hepatocellular carcinoma: How hopeful should we be?. Oncologist. 2006;11:790–800

 S. Sugahara and Y. Oshiro contributed equally to this work.

 This study was supported in part by Grants-in-Aid for Cancer Research 15-9 and H15-006 from the Ministry of Health, Labor and Welfare of the Japanese Government.

 Conflict of interest: none.

PII: S0360-3016(09)00312-5

doi: 10.1016/j.ijrobp.2009.02.030

International Journal of Radiation Oncology * Biology * Physics
Volume 76, Issue 2 , Pages 460-466 , 1 February 2010

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