Proton Beam Therapy in Managing Unresectable Hepatocellular Carcinoma with Bile Duct Invasion
Hepatocellular carcinoma (HCC) with bile duct invasion is a rare and notorious subtype of HCC. This study included patients that had unresectable HCC with bile duct invasion and proton beam therapy between November 2015 and February 2021. Twenty patients fit the inclusion criteria. The median tumor...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/7/1616 |
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| author | Ching-Hsin Lee An-Hsin Chen Sheng-Ping Hung Cheng-En Hsieh Jeng-Hwei Tseng Po-Jui Chen Jen-Yu Cheng Joseph Tung-Chieh Chang Kun-Ming Chan Shi-Ming Lin Chen-Chun Lin Wei-Ting Chen Wan-Yu Chen Bing-Shen Huang |
| author_facet | Ching-Hsin Lee An-Hsin Chen Sheng-Ping Hung Cheng-En Hsieh Jeng-Hwei Tseng Po-Jui Chen Jen-Yu Cheng Joseph Tung-Chieh Chang Kun-Ming Chan Shi-Ming Lin Chen-Chun Lin Wei-Ting Chen Wan-Yu Chen Bing-Shen Huang |
| author_sort | Ching-Hsin Lee |
| collection | DOAJ |
| description | Hepatocellular carcinoma (HCC) with bile duct invasion is a rare and notorious subtype of HCC. This study included patients that had unresectable HCC with bile duct invasion and proton beam therapy between November 2015 and February 2021. Twenty patients fit the inclusion criteria. The median tumor size was 6.3 cm. Nine patients (45.0%) had major vascular invasions. All included patients received the radiation dose of 72.6 gray relative biological effectiveness due to the proximity of porta hepatis and tumor. The median follow-up time was 19.9 months. The median overall survival was 19.9 months among deceased patients. The 1-year cumulative local recurrence rates were 5.3%, with only two patients developing in-field failure. The 1-year and 2-year overall survival rates were 79.4% and 53.3%. The 1-year progression-free survival was 58.9%. Four patients developed radiation-induced liver disease. The 1-year cholangitis-free survival was 55.0%. Skin toxicity was the most common acute toxicity and rarely severe. Eight patients developed ≤ grade 3 gastrointestinal ulcers. Proton beam therapy offers desirable survival outcomes for unresectable HCC patients with bile duct invasion. Optimal local tumor control could also be obtained within acceptable toxicities. |
| first_indexed | 2024-03-09T12:04:48Z |
| format | Article |
| id | doaj.art-840bd275dcf34deb82c35d542a9db8ed |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T12:04:48Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-840bd275dcf34deb82c35d542a9db8ed2023-11-30T22:59:37ZengMDPI AGCancers2072-66942022-03-01147161610.3390/cancers14071616Proton Beam Therapy in Managing Unresectable Hepatocellular Carcinoma with Bile Duct InvasionChing-Hsin Lee0An-Hsin Chen1Sheng-Ping Hung2Cheng-En Hsieh3Jeng-Hwei Tseng4Po-Jui Chen5Jen-Yu Cheng6Joseph Tung-Chieh Chang7Kun-Ming Chan8Shi-Ming Lin9Chen-Chun Lin10Wei-Ting Chen11Wan-Yu Chen12Bing-Shen Huang13Proton and Radiation Therapy Center, Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanDepartment of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanProton and Radiation Therapy Center, Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanProton and Radiation Therapy Center, Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanDepartment of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanProton and Radiation Therapy Center, Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, TaiwanProton and Radiation Therapy Center, Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanDepartment of General Surgery, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanDivision of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei City 100225, TaiwanProton and Radiation Therapy Center, Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and University, Taoyuan City 333423, TaiwanHepatocellular carcinoma (HCC) with bile duct invasion is a rare and notorious subtype of HCC. This study included patients that had unresectable HCC with bile duct invasion and proton beam therapy between November 2015 and February 2021. Twenty patients fit the inclusion criteria. The median tumor size was 6.3 cm. Nine patients (45.0%) had major vascular invasions. All included patients received the radiation dose of 72.6 gray relative biological effectiveness due to the proximity of porta hepatis and tumor. The median follow-up time was 19.9 months. The median overall survival was 19.9 months among deceased patients. The 1-year cumulative local recurrence rates were 5.3%, with only two patients developing in-field failure. The 1-year and 2-year overall survival rates were 79.4% and 53.3%. The 1-year progression-free survival was 58.9%. Four patients developed radiation-induced liver disease. The 1-year cholangitis-free survival was 55.0%. Skin toxicity was the most common acute toxicity and rarely severe. Eight patients developed ≤ grade 3 gastrointestinal ulcers. Proton beam therapy offers desirable survival outcomes for unresectable HCC patients with bile duct invasion. Optimal local tumor control could also be obtained within acceptable toxicities.https://www.mdpi.com/2072-6694/14/7/1616liver cancerhepatic malignancybile duct tumor thrombusbiliary tract invasionictericHCC |
| spellingShingle | Ching-Hsin Lee An-Hsin Chen Sheng-Ping Hung Cheng-En Hsieh Jeng-Hwei Tseng Po-Jui Chen Jen-Yu Cheng Joseph Tung-Chieh Chang Kun-Ming Chan Shi-Ming Lin Chen-Chun Lin Wei-Ting Chen Wan-Yu Chen Bing-Shen Huang Proton Beam Therapy in Managing Unresectable Hepatocellular Carcinoma with Bile Duct Invasion Cancers liver cancer hepatic malignancy bile duct tumor thrombus biliary tract invasion icteric HCC |
| title | Proton Beam Therapy in Managing Unresectable Hepatocellular Carcinoma with Bile Duct Invasion |
| title_full | Proton Beam Therapy in Managing Unresectable Hepatocellular Carcinoma with Bile Duct Invasion |
| title_fullStr | Proton Beam Therapy in Managing Unresectable Hepatocellular Carcinoma with Bile Duct Invasion |
| title_full_unstemmed | Proton Beam Therapy in Managing Unresectable Hepatocellular Carcinoma with Bile Duct Invasion |
| title_short | Proton Beam Therapy in Managing Unresectable Hepatocellular Carcinoma with Bile Duct Invasion |
| title_sort | proton beam therapy in managing unresectable hepatocellular carcinoma with bile duct invasion |
| topic | liver cancer hepatic malignancy bile duct tumor thrombus biliary tract invasion icteric HCC |
| url | https://www.mdpi.com/2072-6694/14/7/1616 |
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