Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers
Abstract Background Intrahepatic cholangiocarcinoma (ICC) is a challenging primary liver cancer with a poor prognosis, especially in unresectable cases. Traditional palliative irradiation is limited in reducing liver doses. This study aimed to evaluate the efficacy and toxicity of respiratory-gated...
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| Format: | Article |
| Language: | English |
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BMC
2024-11-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-024-02550-2 |
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| author | Akihito Okubo Sae Matsumoto Hiroyasu Tamamura Yoshitaka Sato Satoko Asahi Hitoshi Tatebe Kazutaka Yamamoto Keiichiro Matsushita Makoto Sasaki Yoshikazu Maeda Yuji Tameshige Hajime Sunagozaka Hiroyuki Aoyagi Satoshi Shibata Shigeyuki Takamatsu Satoshi Kobayashi |
| author_facet | Akihito Okubo Sae Matsumoto Hiroyasu Tamamura Yoshitaka Sato Satoko Asahi Hitoshi Tatebe Kazutaka Yamamoto Keiichiro Matsushita Makoto Sasaki Yoshikazu Maeda Yuji Tameshige Hajime Sunagozaka Hiroyuki Aoyagi Satoshi Shibata Shigeyuki Takamatsu Satoshi Kobayashi |
| author_sort | Akihito Okubo |
| collection | DOAJ |
| description | Abstract Background Intrahepatic cholangiocarcinoma (ICC) is a challenging primary liver cancer with a poor prognosis, especially in unresectable cases. Traditional palliative irradiation is limited in reducing liver doses. This study aimed to evaluate the efficacy and toxicity of respiratory-gated proton beam therapy without fiducial markers for intrahepatic cholangiocarcinoma. Methods Between October 2011 and February 2022, 24 patients (median [range] age, 71 [41–88] years) were evaluated at our institution. Twelve patients were pathologically diagnosed with ICC. All patients underwent respiratory-gated proton beam therapy at a dose of 48–83.6 (relative biological effectiveness) in 20–38 fractions with four-dimensional computed tomography planning. The median follow-up period was 18.5 (range, 2.0–74.0) months. The median tumor size was 41 (range, 10–134) mm. Twenty-one patients were classified as having Child–Pugh class A, and three patients were classified as having Child–Pugh class B. Local progression was defined as any growth of the irradiated tumor. Results The median survival time was 28 months for all patients. The Kaplan–Meier estimates of the 2-year overall survival, progression-free survival, and local tumor control rates were 51%, 26%, and 73%, respectively. Local tumor control rates were non-inferior to those reported in previous studies using fiducial markers. One patient had grade 4 pleural effusion; however, whether this was an adverse event due to the proton beam therapy was unclear. Conclusions Respiratory-gated proton beam therapy without fiducial markers is an effective and less invasive treatment option for ICC, showing potential for improved local control and tolerable adverse effects. |
| format | Article |
| id | doaj-art-841f5cba66674c6f92b73569c043d40a |
| institution | Kabale University |
| issn | 1748-717X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj-art-841f5cba66674c6f92b73569c043d40a2024-11-17T12:39:42ZengBMCRadiation Oncology1748-717X2024-11-011911910.1186/s13014-024-02550-2Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markersAkihito Okubo0Sae Matsumoto1Hiroyasu Tamamura2Yoshitaka Sato3Satoko Asahi4Hitoshi Tatebe5Kazutaka Yamamoto6Keiichiro Matsushita7Makoto Sasaki8Yoshikazu Maeda9Yuji Tameshige10Hajime Sunagozaka11Hiroyuki Aoyagi12Satoshi Shibata13Shigeyuki Takamatsu14Satoshi Kobayashi15Department of Radiology, Kanazawa University Graduate School of Medical SciencesProton Therapy Center, Fukui Prefectural HospitalProton Therapy Center, Fukui Prefectural HospitalProton Therapy Center, Fukui Prefectural HospitalProton Therapy Center, Fukui Prefectural HospitalProton Therapy Center, Fukui Prefectural HospitalProton Therapy Center, Fukui Prefectural HospitalProton Therapy Center, Fukui Prefectural HospitalProton Therapy Center, Fukui Prefectural HospitalProton Therapy Center, Fukui Prefectural HospitalProton Therapy Center, Fukui Prefectural HospitalDepartment of Gastroenterology, Fukui Prefectural HospitalDepartment of Gastroenterology, Fukui Prefectural HospitalDepartment of Radiology, Kanazawa University Graduate School of Medical SciencesDepartment of Radiology, Kanazawa University Graduate School of Medical SciencesDepartment of Radiology, Kanazawa University Graduate School of Medical SciencesAbstract Background Intrahepatic cholangiocarcinoma (ICC) is a challenging primary liver cancer with a poor prognosis, especially in unresectable cases. Traditional palliative irradiation is limited in reducing liver doses. This study aimed to evaluate the efficacy and toxicity of respiratory-gated proton beam therapy without fiducial markers for intrahepatic cholangiocarcinoma. Methods Between October 2011 and February 2022, 24 patients (median [range] age, 71 [41–88] years) were evaluated at our institution. Twelve patients were pathologically diagnosed with ICC. All patients underwent respiratory-gated proton beam therapy at a dose of 48–83.6 (relative biological effectiveness) in 20–38 fractions with four-dimensional computed tomography planning. The median follow-up period was 18.5 (range, 2.0–74.0) months. The median tumor size was 41 (range, 10–134) mm. Twenty-one patients were classified as having Child–Pugh class A, and three patients were classified as having Child–Pugh class B. Local progression was defined as any growth of the irradiated tumor. Results The median survival time was 28 months for all patients. The Kaplan–Meier estimates of the 2-year overall survival, progression-free survival, and local tumor control rates were 51%, 26%, and 73%, respectively. Local tumor control rates were non-inferior to those reported in previous studies using fiducial markers. One patient had grade 4 pleural effusion; however, whether this was an adverse event due to the proton beam therapy was unclear. Conclusions Respiratory-gated proton beam therapy without fiducial markers is an effective and less invasive treatment option for ICC, showing potential for improved local control and tolerable adverse effects.https://doi.org/10.1186/s13014-024-02550-2Proton beam therapyCholangiocarcinoma4D-CTRespiratory-gated irradiation |
| spellingShingle | Akihito Okubo Sae Matsumoto Hiroyasu Tamamura Yoshitaka Sato Satoko Asahi Hitoshi Tatebe Kazutaka Yamamoto Keiichiro Matsushita Makoto Sasaki Yoshikazu Maeda Yuji Tameshige Hajime Sunagozaka Hiroyuki Aoyagi Satoshi Shibata Shigeyuki Takamatsu Satoshi Kobayashi Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers Radiation Oncology Proton beam therapy Cholangiocarcinoma 4D-CT Respiratory-gated irradiation |
| title | Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers |
| title_full | Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers |
| title_fullStr | Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers |
| title_full_unstemmed | Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers |
| title_short | Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers |
| title_sort | respiratory gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers |
| topic | Proton beam therapy Cholangiocarcinoma 4D-CT Respiratory-gated irradiation |
| url | https://doi.org/10.1186/s13014-024-02550-2 |
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