No Deterioration in Clinical Outcomes of Carbon Ion Radiotherapy for Sarcopenia Patients with Hepatocellular Carcinoma

Abstract

Abstract. Background/Aim: The relationship between sarcopenia and prognosis in carbon ion radiotherapy (C-ion RT) for hepatocellular carcinoma (HCC) has not yet been reported 66% and 77%, respectively (p=0.51) . Conclusion: Sarcopenia was not a prognostic factor for patients with HCC treated with C-ion RT, which was effective in HCC patients with sarcopenia without worsening the OS.The number of elderly patients with age-related loss of skeletal muscle mass (primary sarcopenia) has been on the rise in recent times. In addition, patients with cancer suffer from various metabolic disorders and malnutrition that may cause secondary sarcopenia, which is characterized by a loss of skeletal muscle mass in an early stage, unlike malnutrition which is caused by starvation. Several researchers reported that preoperative skeletal muscle mass is associated with the prognosis of cancers (1-4).Bioelectrical impedance method is frequently used for assessing skeletal muscle mass. Recently, computed tomography (CT) and magnetic resonance imaging (MRI) have been well established for the measurement of skeletal muscle mass at the third lumbar vertebrae level because of objectivity and accuracy (5).Hepatocellular carcinoma (HCC) is the sixth-most frequently occurring cancer type and the third major cause of cancer-related death worldwide (6). Numerous local treatment options can be employed for treating HCC, with particle therapy, such as proton beam therapy and carbon ion radiotherapy (C-ion RT), being one of the less-invasive options (7,8). Most patients with HCC have a history of chronic liver disease resulting from alcohol abuse, or infection with hepatitis C or B virus, so that patients with HCC already are in a state of secondary sarcopenia caused by cirrhosis or chronic hepatitis. Harimoto et al. reported the clinical outcomes of surgery and noted a remarkable difference in overall survival (OS) because of the difference in preoperative skeletal muscle mass (2). However, the relationship between sarcopenia and prognosis in particle therapy for HCC has not yet been reported. In the present study, a retrospective analysis was conducted on the presence or absence of sarcopenia before C-ion RT as a prognostic factor for HCC. Patients and MethodsPatients. This retrospective analysis was performed using the medical records of patients treated with C-ion RT for HCC at our hospital between September 2010 and December 2016. The diagnosis of all patients with HCC was confirmed histologically or by the presence of typical hallmarks of HCC using imaging 3579

Carbon ion radiotherapy for patients with hepatocellular carcinoma in the caudate lobe

“…35 In this study, five of nine patients died of HCC, suggesting that the survival outcome was worse than that reported in other studies of C-ion RT for HCC.17, 36,37 This is probably because this study RT can provide excellent LC probability even for large tumors. 38,39 Collectively, our findings support that C-ion RT is a promising effective alternative therapy in patients with HCCCL in whom surgery can be challenging.…”

Improved clinical outcome using transarterial chemoembolization combined with radiofrequency ablation for patients in Barcelona clinic liver cancer stage A or B hepatocellular carcinoma regardless of tumor size: results of a single-center retrospective case control study

“…In recent years, charged particle therapy (CPT), a relatively novel, non-invasive and promising treatment option, has made remarkable progress in the treatment of HCC [36–38]. Protons (proton beam therapy, PBT) and carbon ions (carbon ion therapy, CIT) are the most commonly used particles of CPT.…”

A comparison of carbon ion radiotherapy and transarterial chemoembolization treatment outcomes for single hepatocellular carcinoma: a propensity score matching study

“…Previous studies involving C-ion RT have shown encouraging clinical outcomes that indicate C-ion RT would be an alternative treatment option for patients for which surgery or RFA are not viable options [12–17, 29]. Shibuya et al demonstrated clinical outcomes of C-ion RT for HCC in a multi-institutional retrospective analysis and reported 2-year OS and LC rates for single HCC of 84 and 87%, respectively [13].…”