Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysis
Abstract Background Proton radiotherapy has a dosimetric advantage over photon radiotherapy. Many retrospective studies have shown promising results with proton radiotherapy in treating hepatocellular carcinoma (HCC). However, clinical evidence demonstrating the benefit of protons over photons is st...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-020-01605-4 |
| _version_ | 1819227676077981696 |
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| author | Jen-Yu Cheng Chieh-Min Liu Yu-Ming Wang Hsuan-Chih Hsu Eng-Yen Huang Tzu-Ting Huang Ching-Hsin Lee Sheng-Ping Hung Bing-Shen Huang |
| author_facet | Jen-Yu Cheng Chieh-Min Liu Yu-Ming Wang Hsuan-Chih Hsu Eng-Yen Huang Tzu-Ting Huang Ching-Hsin Lee Sheng-Ping Hung Bing-Shen Huang |
| author_sort | Jen-Yu Cheng |
| collection | DOAJ |
| description | Abstract Background Proton radiotherapy has a dosimetric advantage over photon radiotherapy. Many retrospective studies have shown promising results with proton radiotherapy in treating hepatocellular carcinoma (HCC). However, clinical evidence demonstrating the benefit of protons over photons is still limited. We therefore compared the clinical outcomes of the two modalities using medical research databases from our medical foundation. Methods We conducted a propensity score-matched cohort study based on our multi-institution medical organization research database. From January 2007 to January 2018, a total of 413 patients (photon: 349; proton: 64) who were diagnosed with HCC and primarily treated with radiotherapy with curative intent were enrolled. Overall survival (OS) and radiation-induced liver disease (RILD) were assessed. Stratified analysis was also performed to evaluate the heterogeneous effects of the two arms. Results A total of 110 patients (photon: 55; proton: 55) were analyzed in the propensity-matched series. The matched groups were balanced for baseline tumor risk factors. Cox regression analysis revealed a significant survival benefit in the proton group (p = 0.032, HR 0.56, 95% CI 0.33–0.96). The median overall survival in the proton group was not reached and that in the photon group was 17.4 months. The biological equivalent dose of radiotherapy was significantly higher in the proton group than in the photon group (median, 96.56 Gray [relative biological effectiveness] vs. 62.5 Gray, p < 0.001). The risk of RILD was significantly lower in the proton group (11.8% vs. 36%, p = 0.004). Conclusions Proton radiotherapy could deliver a higher radiation dose than photon radiotherapy without increasing the risk of RILD and result in a better overall survival rate for those diagnosed with HCC and treated with radiotherapy with curative intent. |
| first_indexed | 2024-12-23T10:45:10Z |
| format | Article |
| id | doaj.art-59c626fbc28341d1a98dc6e53ad5d4af |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-23T10:45:10Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-59c626fbc28341d1a98dc6e53ad5d4af2022-12-21T17:50:02ZengBMCRadiation Oncology1748-717X2020-06-0115111010.1186/s13014-020-01605-4Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysisJen-Yu Cheng0Chieh-Min Liu1Yu-Ming Wang2Hsuan-Chih Hsu3Eng-Yen Huang4Tzu-Ting Huang5Ching-Hsin Lee6Sheng-Ping Hung7Bing-Shen Huang8Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung UniversityDepartment of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung UniversityDepartment of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung UniversityAbstract Background Proton radiotherapy has a dosimetric advantage over photon radiotherapy. Many retrospective studies have shown promising results with proton radiotherapy in treating hepatocellular carcinoma (HCC). However, clinical evidence demonstrating the benefit of protons over photons is still limited. We therefore compared the clinical outcomes of the two modalities using medical research databases from our medical foundation. Methods We conducted a propensity score-matched cohort study based on our multi-institution medical organization research database. From January 2007 to January 2018, a total of 413 patients (photon: 349; proton: 64) who were diagnosed with HCC and primarily treated with radiotherapy with curative intent were enrolled. Overall survival (OS) and radiation-induced liver disease (RILD) were assessed. Stratified analysis was also performed to evaluate the heterogeneous effects of the two arms. Results A total of 110 patients (photon: 55; proton: 55) were analyzed in the propensity-matched series. The matched groups were balanced for baseline tumor risk factors. Cox regression analysis revealed a significant survival benefit in the proton group (p = 0.032, HR 0.56, 95% CI 0.33–0.96). The median overall survival in the proton group was not reached and that in the photon group was 17.4 months. The biological equivalent dose of radiotherapy was significantly higher in the proton group than in the photon group (median, 96.56 Gray [relative biological effectiveness] vs. 62.5 Gray, p < 0.001). The risk of RILD was significantly lower in the proton group (11.8% vs. 36%, p = 0.004). Conclusions Proton radiotherapy could deliver a higher radiation dose than photon radiotherapy without increasing the risk of RILD and result in a better overall survival rate for those diagnosed with HCC and treated with radiotherapy with curative intent.http://link.springer.com/article/10.1186/s13014-020-01605-4Hepatocellular carcinomaProtonPhotonRadiotherapy |
| spellingShingle | Jen-Yu Cheng Chieh-Min Liu Yu-Ming Wang Hsuan-Chih Hsu Eng-Yen Huang Tzu-Ting Huang Ching-Hsin Lee Sheng-Ping Hung Bing-Shen Huang Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysis Radiation Oncology Hepatocellular carcinoma Proton Photon Radiotherapy |
| title | Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysis |
| title_full | Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysis |
| title_fullStr | Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysis |
| title_full_unstemmed | Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysis |
| title_short | Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysis |
| title_sort | proton versus photon radiotherapy for primary hepatocellular carcinoma a propensity matched analysis |
| topic | Hepatocellular carcinoma Proton Photon Radiotherapy |
| url | http://link.springer.com/article/10.1186/s13014-020-01605-4 |
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