Research Papers:

Optimal time of tumour response evaluation and effectiveness of hypofractionated proton beam therapy for inoperable or recurrent hepatocellular carcinoma

Tae Hyun Kim _, Joong-Won Park, Bo Hyun Kim, Dae Yong Kim, Sung Ho Moon, Sang Soo Kim, Ju Hee Lee, Sang Myung Woo, Young-Hwan Koh, Woo Jin Lee and Chang-Min Kim

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Oncotarget. 2018; 9:4034-4043. https://doi.org/10.18632/oncotarget.23428

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Tae Hyun Kim1,*, Joong-Won Park1,*, Bo Hyun Kim1,*, Dae Yong Kim1, Sung Ho Moon1, Sang Soo Kim1, Ju Hee Lee1, Sang Myung Woo1, Young-Hwan Koh1, Woo Jin Lee1 and Chang-Min Kim1

1Center for Liver Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea

*These authors contributed equally to this work

Correspondence to:

Tae Hyun Kim, email: [email protected]

Keywords: hepatocellular carcinoma; tumour response; proton beam therapy

Received: June 10, 2017     Accepted: November 26, 2017     Published: December 19, 2017


Objective: To evaluate the optimal time of tumour response and effectiveness of hypofractionated proton beam therapy (PBT) for hepatocellular carcinoma (HCC).

Results: Overall, treatment was well tolerated with no grade toxicity ≥3. Of 71 patients, 66 patients (93%) eventually reached complete response (CR) after PBT: 93.9% (62 of 66) of patients who reached CR within 12 months, and the remaining 4 patients (6.1%) reached CR at 12.5, 16.2, 19.1 and 21.7 months, respectively. The three-year local progression-free survival (LPFS), relapse-free survival (RFS) and OS rates were 89.9%, 26.8%, and 74.4%, respectively. Multivariate analysis revealed that the tumour response was an independent prognostic factor for LPFS, RFS, and OS.

Conclusion: Most CR was achieved within 1 year after PBT and further salvage treatments in PBT field might be postponed up to approximately 18–24 months. Hypofractionated PBT could be good alternative for HCC patients who are unsuitable for surgical or invasive treatments with curative intent.

Materials and Methods: Seventy-one inoperable or recurrent HCC patients underwent hypofractionated PBT using 66 GyE in 10 fractions. The tumour responses were defined as the maximal tumour response observed during the follow-up period using the modified Response Evaluation Criteria in Solid Tumors criteria.

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