title: Association between pretreatment retention rate of indocyanine green 15 min after administration and life prognosis in patients with HCC treated by proton beam therapy.
abstract: OBJECTIVE
  The Child-Pugh score is often used to judge the outcome of radiotherapy for hepatocellular carcinoma (HCC). The retention rate of indocyanine green 15 min after administration (ICG R15) can also be used to predict prognosis after liver resection. We evaluated the utility of ICG R15 for prediction of outcomes after proton beam therapy (PBT) for HCC.
  
  
  METHODS
  A retrospective evaluation was performed in 250 patients who received PBT between 2002 and 2007. The patients (178 males and 72 females) had a median age of 71 years (range: 43-88). Child-Pugh categories were A (score 5-6), B (7-9), and C (10-15) in 197, 51, and 2 patients, respectively. ICG scores were 0-<10, 10-<20, 20-<30, 30-<40 and ⩾40 in 27, 99, 59, 28 and 37 patients, respectively; including 26, 92, 45, 16 and 18 Child-Pugh A patients and 1, 8, 14, 11, and 17 Child-Pugh B patients, respectively. Survival times from the start of PBT were compared between Child-Pugh A and B patients, and among each ICG group.
  
  
  RESULTS
  The median survival times were 61 months (95% CI: 50-72 months) in all patients, and 64 and 20 months in Child-Pugh A and B patients, respectively (p=0.001), The 3-year survival rates were 72%, 72%, 75%, 63%, and 26% in patients with ICG scores of 0-<10, 10-<20, 20-<30, 30-<40, and ⩾40 (p=0.001); 70%, 75%, 77%, 65%, and 38% in these respective groups in Child-Pugh A patients (p=0.02); and 100%, 57%, 67%, 36%, and 14% in Child-Pugh B patients (p=0.173, not significant). Multivariate analysis showed that low ICG R15 and the absence of portal vein tumor thrombus were associated with good survival.
  
  
  CONCLUSIONS
  Pretreatment ICG R15 is a useful prognostic factor for prediction of outcome of PBT in HCC patients, especially in those with Child-Pugh A liver function.
authors.affiliation: Proton Medical Research Center, University of Tsukuba, Japan; Department of Radiation Oncology, University of Tsukuba, Japan. Electronic address: mizumoto1717@hotmail.com.
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizumoto
authors.affiliation: Proton Medical Research Center, University of Tsukuba, Japan; Department of Radiation Oncology, University of Tsukuba, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Oshiro
authors.affiliation: Proton Medical Research Center, University of Tsukuba, Japan; Department of Radiation Oncology, University of Tsukuba, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Okumura
authors.affiliation: Department of Gastroenterology, University of Tsukuba, Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Proton Medical Research Center, University of Tsukuba, Japan; Department of Radiation Oncology, University of Tsukuba, Japan.
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Fukumitsu
authors.affiliation: Department of Gastroenterology, University of Tsukuba, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Abei
authors.affiliation: Proton Medical Research Center, University of Tsukuba, Japan; Department of Radiation Oncology, University of Tsukuba, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishikawa
authors.affiliation: Proton Medical Research Center, University of Tsukuba, Japan; Department of Radiation Oncology, University of Tsukuba, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Ohnishi
authors.affiliation: Proton Medical Research Center, University of Tsukuba, Japan; Department of Radiation Oncology, University of Tsukuba, Japan.
authors.forename: Haruko
authors.initials: H
authors.lastname: Numajiri
authors.affiliation: Proton Medical Research Center, University of Tsukuba, Japan; Department of Radiation Oncology, University of Tsukuba, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuboi
authors.affiliation: Proton Medical Research Center, University of Tsukuba, Japan; Department of Radiation Oncology, University of Tsukuba, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sakurai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000401:mortality / Q000532:radiotherapy*; D004396:Coloring Agents / Q000493:pharmacokinetics; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics; D053208:Kaplan-Meier Estimate; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000378:metabolism / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D061766:Proton Therapy / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green
keywords: HCC; Hepatocellular carcinoma; ICG 15; Proton beam therapy; Radiotherapy