Y. Matsuzaki et al., A NEW, EFFECTIVE, AND SAFE THERAPEUTIC OPTION USING PROTON IRRADIATION FOR HEPATOCELLULAR-CARCINOMA, Gastroenterology, 106(4), 1994, pp. 1032-1041
Background/Aims: Conventional radiation is almost useless for hepatoce
llular carcinoma (HCC) because of the severe adverse effects of the ir
radiation to the accompanying liver cirrhosis. In contrast, the proton
beam has Bragg peak, which limits distribution of the beam. The aim o
f this study was to prove the usefulness of proton irradiation for HCC
. Methods: The proton irradiation was performed in 32 nodular lesions
in 24 patients with HCC who had unresectable tumors or serious complic
ations; the proton irradiation was performed either as monotherapy (15
lesions) or as combination therapy to insufficient Lipiodol-targeted
chemotherapy (Kodama Co. Ltd., Tokyo, Japan) (17 lesions). The energy
was 250 MeV, and 50-87 Gy (76.5 +/- 9.5, mean +/- SD) in total was irr
adiated for a time period of 17-69 days. Results: After 1 year, size r
eduction was seen in 12 out of 13 lesions (92%) in the monotherapy gro
up and 9 out of 9 lesions (100%) in the combination therapy group; aft
er 2 years, size reduction was seen 4 out of 5 lesions (80%) in the mo
notherapy group and 5 out of 5 lesions (100%) in the combination thera
py group. Local tumor control has being assured for 2 years of the obs
ervation, which is continuing for another 2 years. None of the patient
s have experienced any serious adverse effects. Conclusions: These res
ults show that proton irradiation is a new, safe, and effective therap
eutic option in cases of HCC, even in patients with unresectable tumor
s or those with serious complications.