title: Proton beam therapy for hepatocellular carcinoma located adjacent to the alimentary tract.
abstract: OBJECTIVE
  To evaluate the safety and effectiveness of proton beam therapy for hepatocellular carcinoma (HCC) located adjacent to the alimentary tract.
  
  
  METHODS
  Forty-seven patients (median age, 69 years; range, 43-82 years) who had HCC located within 2 cm of the alimentary tract underwent proton beam therapy. Liver damage according to the Child-Pugh classification was Class A in 35 patients, Class B in 9, and Class C in 3. Treatment protocols of the early 16 patients and the late 31 patients were 72.6 GyE in 22 fractions and 77 GyE in 35 fractions, respectively.
  
  
  RESULTS
  During the median follow-up period of 23 months, 24 patients died; the remaining 23 patients were alive until September 2008. The median overall survival was 33.9 months (95% confidence interval [CI], 10.8-57.0 months). Actuarial overall and local progression-free survival rates at 3 years were 50.0% and 88.1%, respectively. Grade 2 and 3 alimentary tract hemorrhage was observed in 3 (6.4%) and 1 (2.1%) patients, respectively.
  
  
  CONCLUSIONS
  Our proton beam therapy strategy for HCC located adjacent to the alimentary tract seems to be effective but should be performed with caution.
authors.affiliation: Department of Radiation Oncology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Nakayama
authors.forename: Shinji
authors.initials: S
authors.lastname: Sugahara
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Fukuda
authors.forename: Masato
authors.initials: M
authors.lastname: Abei
authors.forename: Junichi
authors.initials: J
authors.lastname: Shoda
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sakurai
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuboi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsuzaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Tokuuye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D004064:Digestive System / Q000528:radiation effects*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D061766:Proton Therapy; D011522:Protons
chemical_list: D011522:Protons