A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity

Background: For small primary liver tumors, favorable outcomes have been reported with both of proton beam therapy (PBT) and X-ray therapy (XRT). However, no clear criteria have been proposed in the cases for which and when of PBT or XRT has to be used. The aim of this study is to investigate cases...

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Main Authors: Yusuke Uchinami, Norio Katoh, Ryusuke Suzuki, Takahiro Kanehira, Masaya Tamura, Seishin Takao, Taeko Matsuura, Naoki Miyamoto, Yoshihiro Fujita, Fuki Koizumi, Hiroshi Taguchi, Koichi Yasuda, Kentaro Nishioka, Isao Yokota, Keiji Kobashi, Hidefumi Aoyama
Format: Article
Language:English
Published: Elsevier 2022-07-01
Series:Clinical and Translational Radiation Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405630822000416
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author Yusuke Uchinami
Norio Katoh
Ryusuke Suzuki
Takahiro Kanehira
Masaya Tamura
Seishin Takao
Taeko Matsuura
Naoki Miyamoto
Yoshihiro Fujita
Fuki Koizumi
Hiroshi Taguchi
Koichi Yasuda
Kentaro Nishioka
Isao Yokota
Keiji Kobashi
Hidefumi Aoyama
author_facet Yusuke Uchinami
Norio Katoh
Ryusuke Suzuki
Takahiro Kanehira
Masaya Tamura
Seishin Takao
Taeko Matsuura
Naoki Miyamoto
Yoshihiro Fujita
Fuki Koizumi
Hiroshi Taguchi
Koichi Yasuda
Kentaro Nishioka
Isao Yokota
Keiji Kobashi
Hidefumi Aoyama
author_sort Yusuke Uchinami
collection DOAJ
description Background: For small primary liver tumors, favorable outcomes have been reported with both of proton beam therapy (PBT) and X-ray therapy (XRT). However, no clear criteria have been proposed in the cases for which and when of PBT or XRT has to be used. The aim of this study is to investigate cases that would benefit from PBT based on the predicted rate of hepatic toxicity. Materials and methods: Eligible patients were those who underwent PBT for primary liver tumors with a maximum diameter of ≤ 5 cm and Child-Pugh grade A (n = 40). To compare the PBT-plan, the treatment plan using volumetric modulated arc therapy was generated as the XRT-plan. The rate of predicted hepatic toxicity was estimated using five normal tissue complication probability (NTCP) models with three different endpoints. The differences in NTCP values (ΔNTCP) were calculated to determine the relative advantage of PBT. Factors predicting benefits of PBT were analyzed by logistic regression analysis. Results: From the dose-volume histogram comparisons, an advantage of PBT was found in sparing of the normal liver receiving low doses. The factors predicting the benefit of PBT differed depending on the selected NTCP model. From the five models, the total tumor diameter (sum of the target tumors), location (hepatic hilum vs other), and number of tumors (1 vs 2) were significant factors. Conclusions: From the radiation-related hepatic toxicity, factors were identified to predict benefits of PBT in primary liver tumors with Child-Pugh grade A, with the maximum tumor diameter of ≤ 5 cm.
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spelling doaj.art-f8033a8b7cb849e1858d9b1f274b55d42022-12-22T03:28:40ZengElsevierClinical and Translational Radiation Oncology2405-63082022-07-01357075A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicityYusuke Uchinami0Norio Katoh1Ryusuke Suzuki2Takahiro Kanehira3Masaya Tamura4Seishin Takao5Taeko Matsuura6Naoki Miyamoto7Yoshihiro Fujita8Fuki Koizumi9Hiroshi Taguchi10Koichi Yasuda11Kentaro Nishioka12Isao Yokota13Keiji Kobashi14Hidefumi Aoyama15Department of Radiation Oncology, Hokkaido University Faculty of Medicine, North 15 West 7, Kita-ku, Sapporo, Hokkaido 060-8638, JapanDepartment of Radiation Oncology, Hokkaido University Faculty of Medicine, North 15 West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan; Corresponding author.Department of Medical Physics, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Medical Physics, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Medical Physics, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Medical Physics, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Medical Physics, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Medical Physics, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Radiation Oncology, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Radiation Oncology, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Radiation Oncology, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Radiation Oncology, Hokkaido University Hospital, North 14 West 5, Kita-ku, Sapporo, Hokkaido 060-8648, JapanDepartment of Radiation Medical Science and Engineering, Hokkaido University Faculty of Medicine, North 15 West 7, Kita-ku, Sapporo, Hokkaido 060-8638, JapanDepartment of Biostatistics, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, Hokkaido 060-8638, JapanDepartment of Radiation Medical Science and Engineering, Hokkaido University Faculty of Medicine, North 15 West 7, Kita-ku, Sapporo, Hokkaido 060-8638, JapanDepartment of Radiation Oncology, Hokkaido University Faculty of Medicine, North 15 West 7, Kita-ku, Sapporo, Hokkaido 060-8638, JapanBackground: For small primary liver tumors, favorable outcomes have been reported with both of proton beam therapy (PBT) and X-ray therapy (XRT). However, no clear criteria have been proposed in the cases for which and when of PBT or XRT has to be used. The aim of this study is to investigate cases that would benefit from PBT based on the predicted rate of hepatic toxicity. Materials and methods: Eligible patients were those who underwent PBT for primary liver tumors with a maximum diameter of ≤ 5 cm and Child-Pugh grade A (n = 40). To compare the PBT-plan, the treatment plan using volumetric modulated arc therapy was generated as the XRT-plan. The rate of predicted hepatic toxicity was estimated using five normal tissue complication probability (NTCP) models with three different endpoints. The differences in NTCP values (ΔNTCP) were calculated to determine the relative advantage of PBT. Factors predicting benefits of PBT were analyzed by logistic regression analysis. Results: From the dose-volume histogram comparisons, an advantage of PBT was found in sparing of the normal liver receiving low doses. The factors predicting the benefit of PBT differed depending on the selected NTCP model. From the five models, the total tumor diameter (sum of the target tumors), location (hepatic hilum vs other), and number of tumors (1 vs 2) were significant factors. Conclusions: From the radiation-related hepatic toxicity, factors were identified to predict benefits of PBT in primary liver tumors with Child-Pugh grade A, with the maximum tumor diameter of ≤ 5 cm.http://www.sciencedirect.com/science/article/pii/S2405630822000416Primary liver tumorsNTCP modelModel-based selection
spellingShingle Yusuke Uchinami
Norio Katoh
Ryusuke Suzuki
Takahiro Kanehira
Masaya Tamura
Seishin Takao
Taeko Matsuura
Naoki Miyamoto
Yoshihiro Fujita
Fuki Koizumi
Hiroshi Taguchi
Koichi Yasuda
Kentaro Nishioka
Isao Yokota
Keiji Kobashi
Hidefumi Aoyama
A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity
Clinical and Translational Radiation Oncology
Primary liver tumors
NTCP model
Model-based selection
title A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity
title_full A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity
title_fullStr A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity
title_full_unstemmed A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity
title_short A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity
title_sort study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity
topic Primary liver tumors
NTCP model
Model-based selection
url http://www.sciencedirect.com/science/article/pii/S2405630822000416
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