Theodore S Hong1, Thomas F DeLaney2, Harvey J Mamon3, Christopher G Willett4, Beow Y Yeap5, Andrzej Niemierko2, John A Wolfgang2, Hsiao-Ming Lu2, Judith Adams2, Elizabeth A Weyman2, Ronald S Arellano6, Lawrence S Blaszkowsky5, Jill N Allen5, Kenneth K Tanabe7, David P Ryan5, Andrew X Zhu5. 1. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: tshong1@partners.org. 2. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 3. Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts. 4. Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina. 5. Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 6. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 7. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Abstract
PURPOSE: To evaluate the feasibility of a respiratory-gated proton beam therapy for liver tumors. METHODS AND MATERIALS: Fifteen patients were enrolled in a prospective institutional review board-approved protocol. Eligibility criteria included Childs-Pugh A/B cirrhosis, unresectable biopsy- proven hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), or metastatic disease (solid tumors only), 1-3 lesions, and tumor size of ≤6 cm. Patients received 15 fractions to a total dose of 45-75 GyE [gray equivalent] using respiratory-gated proton beam therapy. Gating was performed with an external respiratory position monitoring based system. RESULTS: Of the 15 patients enrolled in this clinical trial, 11 had HCC, 3 had ICC, and 1 had metastasis from another primary. Ten patients had a single lesion, 3 patients had 2 lesions, and 2 patients had 3 lesions. Toxicities were grade 3 bilirubinemia-2, grade 3 gastrointestinal bleed-1, and grade 5 stomach perforation-1. One patient had a marginal recurrence, 3 had hepatic recurrences elsewhere in the liver, and 2 had extrahepatic recurrence. With a median follow-up for survivors of 69 months, 1-, 2-, and 3-year overall survivals are 53%, 40%, and 33%, respectively. Progression-free survivals are 40%, 33%, and 27% at 1, 2, and 3 years, respectively. CONCLUSIONS: Respiratory-gated proton beam therapy for liver tumors is feasible. Phase 2 studies for primary liver tumors and metastatic tumors are underway.
PURPOSE: To evaluate the feasibility of a respiratory-gated proton beam therapy for liver tumors. METHODS AND MATERIALS: Fifteen patients were enrolled in a prospective institutional review board-approved protocol. Eligibility criteria included Childs-Pugh A/B cirrhosis, unresectable biopsy- proven hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), or metastatic disease (solid tumors only), 1-3 lesions, and tumor size of ≤6 cm. Patients received 15 fractions to a total dose of 45-75 GyE [gray equivalent] using respiratory-gated proton beam therapy. Gating was performed with an external respiratory position monitoring based system. RESULTS: Of the 15 patients enrolled in this clinical trial, 11 had HCC, 3 had ICC, and 1 had metastasis from another primary. Ten patients had a single lesion, 3 patients had 2 lesions, and 2 patients had 3 lesions. Toxicities were grade 3 bilirubinemia-2, grade 3 gastrointestinal bleed-1, and grade 5 stomach perforation-1. One patient had a marginal recurrence, 3 had hepatic recurrences elsewhere in the liver, and 2 had extrahepatic recurrence. With a median follow-up for survivors of 69 months, 1-, 2-, and 3-year overall survivals are 53%, 40%, and 33%, respectively. Progression-free survivals are 40%, 33%, and 27% at 1, 2, and 3 years, respectively. CONCLUSIONS: Respiratory-gated proton beam therapy for liver tumors is feasible. Phase 2 studies for primary liver tumors and metastatic tumors are underway.
Authors: Xiaochun Wang; Sunil Krishnan; Xiaodong Zhang; Lei Dong; Tina Briere; Christopher H Crane; Mary Martel; Michael Gillin; Radhe Mohan; Sam Beddar Journal: Med Dosim Date: 2008 Impact factor: 1.482
Authors: Sam S Yoon; Thomas A Aloia; Alex B Haynes; Avinash Kambadakone; Harmeet Kaur; Jean-Nicolas Vauthey; Cristina R Ferrone; Andrew X Zhu; Jennifer Y Wo; Christopher Crane; Theodore S Hong Journal: Pract Radiat Oncol Date: 2013-08-29
Authors: Mark T Lee; John J Kim; Robert Dinniwell; James Brierley; Gina Lockwood; Rebecca Wong; Bernard Cummings; Jolie Ringash; Regina V Tse; Jennifer J Knox; Laura A Dawson Journal: J Clin Oncol Date: 2009-03-02 Impact factor: 44.544
Authors: Young Suk Kim; Jun Won Kim; Won Sup Yoon; Min Kyu Kang; Ik Jae Lee; Tae Hyun Kim; Jin Hee Kim; Hyung-Sik Lee; Hee Chul Park; Hong Seok Jang; Chul Seung Kay; Sang Min Yoon; Mi-Sook Kim; Jinsil Seong Journal: Strahlenther Onkol Date: 2016-08-18 Impact factor: 3.621
Authors: Jana M Kobeissi; Lara Hilal; Charles B Simone; Haibo Lin; Christopher H Crane; Carla Hajj Journal: Cancers (Basel) Date: 2022-06-12 Impact factor: 6.575
Authors: Michael I Lock; Jonathan Klein; Hans T Chung; Joseph M Herman; Edward Y Kim; William Small; Nina A Mayr; Simon S Lo Journal: World J Hepatol Date: 2017-05-18