Pencil Beam Scanning Carbon Ion Radiotherapy for Hepatocellular Carcinoma

作者：Wenna Zhang, Xin Cai, Jiayao Sun, Weiwei Wang, Jingfang Zhao, Qing Zhang, Guoliang Jiang, Zheng Wang · 发表于：Journal of Hepatocellular Carcinoma · 年份：2023 · DOI：10.2147/jhc.s429186 · 被引用次数：8 · 研究领域：Radiation Therapy and Dosimetry、Hepatocellular Carcinoma Treatment and Prognosis、Chemotherapy-induced cardiotoxicity and mitigation

Purpose: Carbon ion radiotherapy (CIRT) has emerged as a promising treatment modality for hepatocellular carcinoma (HCC). However, evidence of using the pencil beam scanning (PBS) technique to treat moving liver tumors remains lacking. The present study investigated the efficacy and toxicity of PBS CIRT in patients with HCC. Methods: Between January 2016 and October 2021, 90 consecutive HCC patients treated with definitive CIRT in our center were retrospectively analyzed. Fifty-eight patients received relative biological effectiveness-weighted doses of 50-70 Gy in 10 fractions, and 32 received 60-67.5 Gy in 15 fractions, which were determined by the tumor location and normal tissue constraints. Active motion-management techniques and necessary strategies were adopted to mitigate interplay effects efficiently. Oncologic outcomes and toxicities were evaluated. Results: The median follow-up time was 28.6 months (range 5.7-74.6 months). The objective response rate was 75.0% for all 90 patients with 100 treated lesions. The overall survival rates at 1-, 2- and 3-years were 97.8%, 83.3% and 75.4%, respectively. The local control rates at 1-, 2- and 3-years were 96.4%, 96.4% and 93.1%, respectively. Radiation-induced liver disease was not documented, and 4 patients (4.4%) had their Child-Pugh score elevated by 1 point after CIRT. No grade 3 or higher acute non-hematological toxicities were observed. Six patients (6.7%) experienced grade 3 or higher late toxicities. Conclusion: The a...