Comparison of Dose Distributions When Using Carbon Ion Radiotherapy Versus Intensity-modulated Radiotherapy for Hepatocellular Carcinoma With Macroscopic Vascular Invasion: A Retrospective Analysis

Shiba, Shintaro; Shibuya, Kazuhiko; Kawashima, Motohiro; Okano, Naoko; Kaminuma, Takuya; Okamoto, Masahiko; Kubota, Yoshiki; Nakano, Takashi; Ohno, Tatsuya

doi:10.21873/anticanres.13974

Cited by 13 publications

(13 citation statements)

References 16 publications

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“…Primarily, TMIH and non-invasiveness are the crucial considerations for decision-making ( 7 – 12 ). What is more, CIRT possesses multidimensional superiorities compared with either photon or proton radiotherapy ( 21 , 29 , 63 , 64 ). CIRT is superior to SABR for treating patients with liver cancer due to its unique advantages in terms of target conformity and normal liver tissue sparing, relative biological effectiveness (RBE), duration of treatment, risk of subsequent primary cancers, and so on ( 20 , 21 , 29 , 30 , 35 , 63 – 68 ).…”

Section: Discussionmentioning

confidence: 99%

“…What is more, CIRT possesses multidimensional superiorities compared with either photon or proton radiotherapy ( 21 , 29 , 63 , 64 ). CIRT is superior to SABR for treating patients with liver cancer due to its unique advantages in terms of target conformity and normal liver tissue sparing, relative biological effectiveness (RBE), duration of treatment, risk of subsequent primary cancers, and so on ( 20 , 21 , 29 , 30 , 35 , 63 – 68 ). Additionally, CIRT is beneficial to protect the immune system and activate specific anti-cancer immunity by triggering the immunoreaction on account of its excellent superiorities in the aspects of dose localization and RBE ( 21 – 28 ), which is extremely significant for patients to fight against cancer and SARS-CoV-2 synchronously ( 7 – 12 ).…”

Section: Discussionmentioning

confidence: 99%

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Carbon Ion Radiotherapy Acts as the Optimal Treatment Strategy for Unresectable Liver Cancer During the Coronavirus Disease 2019 Crisis

Wang

et al. 2021

Front. Public Health

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The coronavirus disease 2019 (COVID-19) pandemic has greatly disrupted the normal treatment of patients with liver cancer and increased their risk of death. The weight of therapeutic safety was significantly amplified for decision-making to minimize the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Herein, the safety and effectiveness of carbon ion radiotherapy (CIRT) for unresectable liver cancer (ULC) were evaluated, and Chinese experiences were shared to solve the predicament of ULC treatment caused by SARS-CoV-2. Worldwide studies were collected to evaluate CIRT for ULC as the world has become a community due to the COVID-19 pandemic. We not only searched five international databases including the Cochrane Library, Web of Science, PubMed, Embase, and Scopus but also performed supplementary retrieval with other sources. Chinese experiences of fighting against COVID-19 were introduced based on the advancements of CIRT in China and a prospective clinical trial of CIRT for treating ULC. A total of 19 studies involving 813 patients with ULC were included in the systematic review. The qualitative synthetic evaluation showed that compared with transarterial chemoembolization (TACE), CIRT could achieve superior overall survival, local control, and relative hepatic protection. The systematic results indicated that non-invasive CIRT could significantly minimize harms to patients with ULC and concurrently obtain superior anti-cancer effectiveness. According to the Chinese experience, CIRT allows telemedicine within the hospital (TMIH) to keep a sufficient person-to-person physical distance in the whole process of treatment for ULC, which is significant for cutting off the transmission route of SARS-CoV-2. Additionally, CIRT could maximize the utilization rate of hospitalization and outpatient care (UHO). Collectively, CIRT for ULC patients not only allows TMIH and the maximized UHO but also has the compatible advantages of safety and effectiveness. Therefore, CIRT should be identified as the optimal strategy for treating appropriate ULC when we need to minimize the risk of SARS-CoV-2 infection and to improve the capacity of medical service in the context of the unprecedented COVID-19 crisis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carbon Ion Radiotherapy Acts as the Optimal Treatment Strategy for Unresectable Liver Cancer During the Coronavirus Disease 2019 Crisis

Wang

et al. 2021

Front. Public Health

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“…C-ion RT delivers higher local doses than X-ray RT (i.e., stereotactic body RT and intensity-modulated RT) [ 8 , 9 ]; also, the modality enables delivery of a reduced dose to the liver while ensuring good target coverage. Therefore, the effect on liver function is minimal, and exacerbation of poor liver function and radiation-induced liver disease after C-ion RT are rare [ 3 – 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Use of carbon-ion radiotherapy (C-ion RT) to treat HCC has shown favorable clinical results, with minimal liver damage [ 3 – 6 ]. These favorable results are due to the biological and physical advantages that C-ion RT has over X-ray RT [ 7 – 9 ]. However, C-ion RT for HCC with HE presents technical difficulties in patients who cannot maintain a static position during irradiation due to flapping tremor or disturbance of consciousness.…”

Section: Introductionmentioning

confidence: 99%

Carbon-ion radiotherapy subsequent to balloon-occluded retrograde transvenous obliteration for hepatocellular carcinoma with hepatic encephalopathy: a multidisciplinary approach

Osu

Shiba

Shibuya

et al. 2021

Clin J Gastroenterol

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Radical treatments of hepatocellular carcinoma (HCC) with hepatic encephalopathy (HE) can be often difficult due to poor liver function or disturbance of consciousness. An effective treatment requires a combinatorial approach incorporating a treatment for HE and radical therapy for HCC that does not compromise liver function. Here, we report a case of a 78-year-old Japanese male with HCC and HE caused by splenorenal shunt. Serum ammonia levels were high. He was not suitable for surgery, percutaneous radiofrequency ablation, or transarterial chemoembolization due to the location of the tumor and poor liver function, which included HE. Thus, he underwent BRTO, with an immediate improvement in both HE and serum ammonia levels. After BRTO, he received C-ion RT as a radical treatment for HCC. After treatment, HCC was well controlled; however, at 35 months post-initiation of C-ion RT, he developed local recurrence without a further reduction in liver function status. Therefore, we repeated C-ion RT. The patient remains alive at 3 months post-treatment, with no evidence of local recurrence, distant metastasis, or toxicity. Although this is a single case report, it suggests that a combinatorial treatment consisting of BRTO and C-ion RT may increase survival rates of patients with HCC and HE.

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“…Hence, particle RT can obtain a satisfactory dose distribution with very few beams (only two to four beams are usually required). Recently, a number of studies (4)(5)(6)(7)(8)(9)(10)(11)(12) have reported promising clinical outcomes with particle therapy for various tumors.…”

Section: Introductionmentioning

confidence: 99%

Robust Angle Selection in Particle Therapy

Zhou

Kubota

et al. 2021

Front. Oncol.

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The popularity of particle radiotherapy has grown exponentially over recent years owing to the marked advantage of the depth–dose curve and its unique biological property. However, particle therapy is sensitive to changes in anatomical structure, and the dose distribution may deteriorate. In particle therapy, robust beam angle selection plays a crucial role in mitigating inter- and intrafractional variation, including daily patient setup uncertainties and tumor motion. With the development of a rotating gantry, angle optimization has gained increasing attention. Currently, several studies use the variation in the water equivalent thickness to quantify anatomical changes during treatment. This method seems helpful in determining better beam angles and improving the robustness of planning. Therefore, this review will discuss and summarize the robust beam angles at different tumor sites in particle radiotherapy.

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Comparison of Dose Distributions When Using Carbon Ion Radiotherapy Versus Intensity-modulated Radiotherapy for Hepatocellular Carcinoma With Macroscopic Vascular Invasion: A Retrospective Analysis

Cited by 13 publications

References 16 publications

Carbon Ion Radiotherapy Acts as the Optimal Treatment Strategy for Unresectable Liver Cancer During the Coronavirus Disease 2019 Crisis

Carbon Ion Radiotherapy Acts as the Optimal Treatment Strategy for Unresectable Liver Cancer During the Coronavirus Disease 2019 Crisis

Carbon-ion radiotherapy subsequent to balloon-occluded retrograde transvenous obliteration for hepatocellular carcinoma with hepatic encephalopathy: a multidisciplinary approach

Robust Angle Selection in Particle Therapy

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