Is there a role for proton therapy in the treatment of hepatocellular carcinoma? A systematic review

Radiotherapy and Oncology, 2014, 111, (1), pag. 1-10

Dionisi F1, Widesott L1,2, Lorentini S1, Amichetti M1.

1    Agenzia Provinciale per la Protonterapia (ATreP), Trento, Italy; Proton therapy Unit, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy.

2    Department of Physics, Swiss Institute of Technology (ETH), Zurich, Switzerland.

This paper aimed to review the literature concerning the use of proton therapy systematically in the treatment of hepatocellular carcinoma, focusing on clinical results and technical issues. The literature search was conducted according to a specific protocol in the Medline and Scopus databases by two independent researchers covering the period of 1990-2012. Both clinical and technical studies referring to a population of patients actually treated with protons were included. The PRISMA guidelines for reporting systematic reviews were followed. A final set of 16 studies from seven proton therapy institutions worldwide were selected from an initial dataset of 324 reports. Seven clinical studies, five reports on technical issues, three studies on treatment related toxicity and one paper reporting both clinical results and toxicity analysis were retrieved. Four studies were not published as full papers. Passive scattering was the most adopted delivery technique. More than 900 patients with heterogeneous stages of disease were treated with various fractionation schedules. Only one prospective full paper was found. Local control was approximately 80% at 3-5years, average overall survival at 5years was 32%, with data comparable to surgery in the most favorable groups. Toxicity was low (mainly gastrointestinal). Normal liver V0Gy<30%volume and V30Gy<18-25%volume were suggested as cut-off values for hepatic toxicity. The good clinical results of the selected papers are counterbalanced by a low level of evidence. However, the rationale to enroll patients in prospective studies appears to be strong.

HOW CAN WE HELP YOU?
Name
Surname
Your email address
Telephone
Your request
Provincia autonoma di Trento, in conformità con l'art. 13 della Legge 196/2003 e successive modifiche, dichiara che i dati personali qui raccolti hanno finalità di registrare l'utente, attivare nei suoi confronti il servizio richiesto e fornirgli informazioni sull'attività ed i servizi del Centro di Protonterapia, nonché sulle iniziative e le attività promosse dallo stesso. Tali dati verranno trattati elettronicamente in conformità con le leggi vigenti; si garantisce la riservatezza degli stessi e che non saranno oggetto di comunicazione o diffusione a terzi. L'interessato può esercitare in qualsiasi momento i diritti di cui all'art. 7 della suddetta legge (accesso correzione e cancellazione dei dati), rivolgendosi a Provincia autonoma di Trento, uff.informazioni@provincia.tn.it.
PROTON THERAPY CENTRE - TRENTO
ADDRESS:
Via Al Desert n.14, 38123 Trento

MAIL:
protonterapia@apss.tn.it

TELEPHONE:
+39 0461 1953100

HOURS: Lun - Ven | 8.30 - 16.00