Wei-Xiang Qi1, Shen Fu2, Qing Zhang1, Xiao-Mao Guo3. 1. Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, China. 2. Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, China; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, China. Electronic address: fushen2014@sina.com. 3. Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, China; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, China.
Abstract
PURPOSE: To perform a systematic review and meta-analysis to compare the clinical outcomes and toxicity of hepatocellular carcinoma (HCC) patients treated with charged particle therapy (CPT) with those of individuals receiving photon therapy. METHODS: We identified relevant clinical studies through searching databases. Primary outcomes of interest were overall survival (OS) at 1, 3, 5 years, progression-free survival (PFS), and locoregional control (LC) at longest follow-up. RESULTS: 73 cohorts from 70 non-comparative observational studies were included. Pooled OS was significantly higher at 1, 3, 5 years for CPT than for conventional radiotherapy (CRT) [relative risk (RR) 1·68, 95% CI 1·22-2·31; p<0·001; RR 3.46, 95% CI: 1.72-3.51, p<0.001; RR 25.9, 95% CI: 1.64-408.5, p=0.02; respectively]. PFS and LC at longest follow-up was also significantly higher for CPT than for CRT (p=0·013 and p<0.001, respectively), while comparable efficacy was found between CPT and SBRT in terms of OS, PFS and LC at longest follow-up. Additionally, high-grade acute and late toxicity associated with CPT was lower than that of CRT and SBRT. CONCLUSION: Survival rates for CPT are higher than those for CRT, but similar to SBRT in patients with HCC. Toxicity tends to be lower for CPT compared to photon radiotherapy.
PURPOSE: To perform a systematic review and meta-analysis to compare the clinical outcomes and toxicity of hepatocellular carcinoma (HCC) patients treated with charged particle therapy (CPT) with those of individuals receiving photon therapy. METHODS: We identified relevant clinical studies through searching databases. Primary outcomes of interest were overall survival (OS) at 1, 3, 5 years, progression-free survival (PFS), and locoregional control (LC) at longest follow-up. RESULTS: 73 cohorts from 70 non-comparative observational studies were included. Pooled OS was significantly higher at 1, 3, 5 years for CPT than for conventional radiotherapy (CRT) [relative risk (RR) 1·68, 95% CI 1·22-2·31; p<0·001; RR 3.46, 95% CI: 1.72-3.51, p<0.001; RR 25.9, 95% CI: 1.64-408.5, p=0.02; respectively]. PFS and LC at longest follow-up was also significantly higher for CPT than for CRT (p=0·013 and p<0.001, respectively), while comparable efficacy was found between CPT and SBRT in terms of OS, PFS and LC at longest follow-up. Additionally, high-grade acute and late toxicity associated with CPT was lower than that of CRT and SBRT. CONCLUSION: Survival rates for CPT are higher than those for CRT, but similar to SBRT in patients with HCC. Toxicity tends to be lower for CPT compared to photon radiotherapy.
Authors: Al B Benson; Michael I D'Angelica; Daniel E Abbott; Thomas A Abrams; Steven R Alberts; Daniel Anaya Saenz; Chandrakanth Are; Daniel B Brown; Daniel T Chang; Anne M Covey; William Hawkins; Renuka Iyer; Rojymon Jacob; Andrea Karachristos; R Kate Kelley; Robin Kim; Manisha Palta; James O Park; Vaibhav Sahai; Tracey Schefter; Carl Schmidt; Jason K Sicklick; Gagandeep Singh; Davendra Sohal; Stacey Stein; G Gary Tian; Jean-Nicolas Vauthey; Alan P Venook; Andrew X Zhu; Karin G Hoffmann; Susan Darlow Journal: J Natl Compr Canc Netw Date: 2017-05 Impact factor: 11.908
Authors: Ashwathy Susan Mathew; Eshetu G Atenafu; Dawn Owen; Chris Maurino; Anthony Brade; James Brierley; Robert Dinniwell; John Kim; Charles Cho; Jolie Ringash; Rebecca Wong; Kyle Cuneo; Mary Feng; Theodore S Lawrence; Laura A Dawson Journal: Eur J Cancer Date: 2020-05-24 Impact factor: 9.162