Evaluation of Liver Function After Proton Beam Therapy for Hepatocellular Carcinoma

Mizumoto, Masashi; Okumura, Toshiyuki; Hashimoto, Takayuki; Fukuda, Kuniaki; Oshiro, Yoshiko; Fukumitsu, Nobuyoshi; Abei, Masato; Kawaguchi, Atsushı; Hayashi, Yasutaka; Ohkawa, A.; Hashii, Haruko; Kanemoto, Ayae; Moritake, Takashi; Tohno, Eriko; Tsuboi, Koji; Sakae, Takeji; Sakurai, Hideyuki

doi:10.1016/j.ijrobp.2011.05.056

Cited by 62 publications

(49 citation statements)

References 42 publications

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“…For example, the percentage volume of nonirradiated normal liver is significantly related to liver function after proton beam therapy [46]. However, no formula calculates the residual liver volume after radiotherapy.…”

Section: Likelihood Of Rild After Radiation Therapymentioning

confidence: 99%

Pathology and images of radiation-induced hepatitis: a review article

et al. 2018

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Recent advances in highly conformal radiotherapies greatly extend the indications for radiotherapy of liver tumors. However, because of poor tolerance to hepatic radiation, estimation of the intensity of irradiation of the liver is important, particularly for a cirrhotic liver. Knowledge of radiation-induced hepatitis is important for understanding how to optimize hepatic radiation therapy. Pathological changes of the irradiated liver, which include perivenular fibrosis, sinusoidal obstruction, and damage to Kupffer cells and hepatocytes, can be visualized using clinical imaging techniques. This review article discusses and illustrates the pathological and radiological changes of hepatic tumors and the surrounding parenchyma of the irradiated liver.

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Section: Likelihood Of Rild After Radiation Therapymentioning

confidence: 99%

Pathology and images of radiation-induced hepatitis: a review article

et al. 2018

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“…This portends to worse outcomes and decreased quality of life. The volume of normal liver sparing has been associated with a decreased risk of advancing Child-Pugh class in cirrhotic patients (28). Other structures in the beam path such as ribs post a risk of late post-radiotherapy complication.…”

Section: Dose Constraint Models For Proton-based Planningmentioning

confidence: 99%

Proton therapy for hepatocellular carcinoma

Ling

Kang

Bush

et al. 2012

Chin. J. Cancer Res.

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Proton radiotherapy has seen an increasing role in the treatment of hepatocellular carcinoma (HCC). Historically, external beam radiotherapy has played a very limited role in HCC due to a high incidence of toxicity to surrounding normal structures. The ability to deliver a high dose of radiation to the tumor is a key factor in improving outcomes in HCC. Advances in photon radiotherapy have improved dose conformity and allowed dose escalation to the tumor. However, despite these advances there is still a large volume of normal liver that receives a considerable radiation dose during treatment. Proton beams do not have an exit dose along the beam path once they enter the body. The inherent physical attributes of proton radiotherapy offer a way to maximize tumor control via dose escalation while avoiding excessive radiation to the remaining liver, thus increasing biological effectiveness. In this review we discuss the physical attributes and rationale for proton radiotherapy in HCC. We also review recent literature regarding clinical outcomes of using proton radiotherapy for the treatment of HCC.

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“…Liver function after PBT is maintained in many cases, but in our experience this is significantly dependent on the percentage volume of normal liver that is not irradiated [10]. Therefore, in cases with a limited normal liver volume, care must be taken to maintain liver function when performing PBT.…”

Section: Discussionmentioning

confidence: 87%

Aggressive proton beam therapy followed by liver transplantation for a patient with large HCC with portal vein tumor thrombus

et al. 2012

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We describe the case of a patient with large hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) who was successfully treated with two courses of proton beam therapy (PBT) followed by liver transplantation. The patient was a 69-year-old man with hepatitis C viral infection who was diagnosed with a diffuse HCC, 8 cm in size, and a PVTT that occluded the right portal vein and reached the main trunk of the portal vein. A large tumor in the right lobe and PVTT in the main and right main portal vein were treated by PBT. PVTT in the left main portal vein developed thereafter and was treated with a second course of PBT. Although the tumor was well controlled with two courses of PBT, liver function gradually deteriorated to an irreversible status 20 months after initiation of the first course of PBT. Liver transplantation was successfully performed to maintain liver function. The patient is still alive with no evidence of disease 7 years after the first course of PBT. This case shows that aggressive PBT can be used for treating advanced HCC, with subsequent liver transplantation for hepatic failure that may be caused by PBT.

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Evaluation of Liver Function After Proton Beam Therapy for Hepatocellular Carcinoma

Cited by 62 publications

References 42 publications

Pathology and images of radiation-induced hepatitis: a review article

Pathology and images of radiation-induced hepatitis: a review article

Proton therapy for hepatocellular carcinoma

Aggressive proton beam therapy followed by liver transplantation for a patient with large HCC with portal vein tumor thrombus

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