title: Proton beam therapy for hepatocellular carcinoma: a retrospective review of 162 patients.
abstract: OBJECTIVE
  We present results of patients with hepatocellular carcinoma (HCC) treated with proton beam therapy.
  
  
  METHODS
  We reviewed 162 patients having 192 HCCs treated from November 1985 to July 1998 by proton beam therapy with or without transarterial embolization and percutaneous ethanol injection. The patients in the present series were considered unsuitable for surgery for various reasons, including hepatic dysfunction, multiple tumors, recurrence after surgical resection, and concomitant illnesses. The median total dose of proton irradiation was 72 Gy in 16 fractions over 29 days.
  
  
  RESULTS
  The overall survival rate for all of the 162 patients was 23.5% at 5 years. The local control rate at 5 years was 86.9% for all 192 tumors among the 162 patients. The degree of impairment of hepatic functions attributable to coexisting liver cirrhosis and the number of tumors in the liver significantly affected patient survival. For 50 patients having least impaired hepatic functions and a solitary tumor, the survival rate at 5 years was 53.5%. The patients had very few acute reactions to treatments and a few late sequelae during and after the treatments.
  
  
  CONCLUSIONS
  Proton beam therapy for patients with HCC is effective, safe, well tolerable, and repeatable. It is the useful treatment mode for either cure or palliation for patients with HCC irrespective of tumor size, tumor location in the liver, insufficient feeding of the tumor with arteries, presence of vascular invasion, impaired hepatic functions, and coexisting intercurrent diseases.
authors.affiliation: Department of Gastroenterology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Chiba
authors.forename: Koichi
authors.initials: K
authors.lastname: Tokuuye
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsuzaki
authors.forename: Shinji
authors.initials: S
authors.lastname: Sugahara
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Chuganji
authors.forename: Kenji
authors.initials: K
authors.lastname: Kagei
authors.forename: Junichi
authors.initials: J
authors.lastname: Shoda
authors.forename: Masaharu
authors.initials: M
authors.lastname: Hata
authors.forename: Masato
authors.initials: M
authors.lastname: Abei
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Igaki
authors.forename: Naomi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Akine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D061766:Proton Therapy; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D011522:Protons
chemical_list: D011522:Protons