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A systematic review of publications on charged particle therapy for hepatocellular carcinoma

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Abstract

Charged particle therapy (proton beam therapy and carbon ion therapy) is a form of radiotherapy which has the unique characteristic of superior depth dose distribution, and has been used for the treatment of hepatocellular carcinoma (HCC) in a limited number of patients, especially in Japan. We undertook a systematic review to define the clinical utility of charged particle therapy for patients with HCC. We searched the MEDLINE database from 1983 to June 2016 to identify clinical studies on charged particle therapy for HCC. Primary outcomes of interest were local control, overall survival, and late radiation morbidities. A total of 13 cohorts from 11 papers were selected from an initial dataset of 78 papers. They included a randomized controlled trial comparing proton beam therapy with transarterial chemoembolization, 9 phase I or II trials and 2 retrospective studies. The reported actuarial local control rates ranged from 71.4–95% at 3 years, and the overall survival rates ranged from 25–42.3% at 5 years. Late severe radiation morbidities were uncommon, and a total of 18 patients with grade ≥3 late adverse events were reported among the 787 patients included in this analysis. Charged particle therapy for HCC was associated with good local control with limited probability of severe morbidities. The cost-effectiveness and the distinctive clinical advantages of charged particle therapies should be clarified in order to become a socially accepted treatment modality for HCC.

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Acknowledgements

The authors would like to thank the following foundation and individuals for their assistance in developing this report. The general incorporated foundation of the Japan Society of Hepatology (Tokyo, Japan) developed and implemented the search strategy and conducted a literature search. Dr. Atsuya Takeda (Ofuna Chuo Hospital) and Dr. Ken Harada (Tokai University) helped with screening and retrieval of the literature review. This study was supported in part by JSPS KAKENHI [Grant numbers 16K10410 (Grant recipient: HI), 15H04901 (Grant recipient: HS), 16K10383 (Grant recipient: TO)].

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Authors and Affiliations

  1. Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Hiroshi Igaki

  2. Department of Radiation Oncology and Proton Medical Research Center, University of Tsukuba, Ibaraki, Japan

    Masashi Mizumoto, Toshiyuki Okumura & Hideyuki Sakurai

  3. Department of Hepatobiliary and Pancreatic Surgery, University of Tokyo, Tokyo, Japan

    Kiyoshi Hasegawa & Norihiro Kokudo

  4. National Center for Global Health and Medicine, Tokyo, Japan

    Norihiro Kokudo

  5. The Committee for Revision of the Clinical Practice Guidelines for Hepatocellular Carcinoma, Japan Society of Hepatology, Tokyo, Japan

    Hiroshi Igaki, Masashi Mizumoto, Toshiyuki Okumura, Kiyoshi Hasegawa, Norihiro Kokudo & Hideyuki Sakurai

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  1. Hiroshi Igaki
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  2. Masashi Mizumoto
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  3. Toshiyuki Okumura
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Correspondence to Hiroshi Igaki.

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Igaki, H., Mizumoto, M., Okumura, T. et al. A systematic review of publications on charged particle therapy for hepatocellular carcinoma. Int J Clin Oncol 23, 423–433 (2018). https://doi.org/10.1007/s10147-017-1190-2

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