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Evaluation of liver function after proton beam therapy for hepatocellular carcinoma.
MedLine Citation:
PMID:  22284041     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: Our previous results for treatment of hepatocellular carcinoma with proton beam therapy (PBT) revealed excellent local control. In this study, we focused on the impact of PBT on normal liver function.
METHODS AND MATERIALS: The subjects were 259 patients treated with PBT at the University of Tsukuba between January 2001 and December 2007. We evaluated the Child-Pugh score pretreatment, on the final day of PBT, and 6, 12, and 24 months after treatment with PBT. Patients who had disease progression or who died with tumor progression at each evaluation point were excluded from the analysis to rule out an effect of tumor progression. An increase in the Child-Pugh score of 1 or more was defined as an adverse event.
RESULTS: Of the 259 patients, 241 had no disease progression on the final day of PBT, and 91 had no progression within 12 months after PBT. In univariate analysis, the percentage volumes of normal liver receiving at least 0, 10, 20, and 30 GyE in PBT (V0, 10, 20, and 30) were significantly associated with an increase of Child-Pugh score at 12 months after PBT. Of the 91 patients evaluated at 12 months, 66 had no increase of Child-Pugh score, 15 had a 1-point increase, and 10 had an increase of ≥2 points. For the Youden index, the optimal cut-offs for V0, V10, V20, and V30 were 30%, 20%, 26%, and 18%, respectively.
CONCLUSION: Our findings indicate that liver function after PBT is significantly related to the percentage volume of normal liver that is not irradiated. This suggests that further study of the relationship between liver function and PBT is required.
Masashi Mizumoto; Toshiyuki Okumura; Takayuki Hashimoto; Kuniaki Fukuda; Yoshiko Oshiro; Nobuyoshi Fukumitsu; Masato Abei; Atsushi Kawaguchi; Yasutaka Hayashi; Ayako Ohkawa; Haruko Hashii; Ayae Kanemoto; Takashi Moritake; Eriko Tohno; Koji Tsuboi; Takeji Sakae; Hideyuki Sakurai
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  82     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-01-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e529-35     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki, Japan; Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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