Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan.
Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan.
Curr Oncol. 2023 Mar 30;30(4):3915-3926. doi: 10.3390/curroncol30040296.
Proton beam therapy (PBT) has been recently reported to achieve excellent tumor control with minimal toxicity in patients with unresectable hepatocellular carcinoma (HCC). Radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) was investigated for larger HCC. This study was designed to evaluate the therapeutic effect of PBT on unresectable HCC in comparison with TACE combined with RFA.
We retrospectively analyzed 70 patients with HCC which was difficult to control by surgical resection or RFA monotherapy, 24 patients treated with PBT and 46 patients with TACE plus RFA. The therapeutic effects were assessed as local progression-free survival (PFS) and overall survival (OS).
The local PFS was more than 65% in 60 months for PBT and TACE plus RFA. The patients treated with PBT showed 82% OS at 60 months post-treatment. In contrast, those treated with TACE plus RFA showed 28% OS. When comparing the changes of ALBI scores in patients with different severities of chronic liver disease, the scores of PBT-treated patients were maintained at the baseline; however, those of TACE plus RFA-treated patients worsened after the treatments.
The results indicated that PBT may show better benefits than TACE plus RFA therapy in terms of OS in patients with unresectable HCC by sparing the non-tumor liver tissues.
质子束治疗（PBT）最近被报道在不可切除的肝细胞癌（HCC）患者中具有优异的肿瘤控制效果，同时毒性最小。射频消融（RFA）联合经导管动脉化疗栓塞（TACE）已被用于治疗更大的 HCC。本研究旨在评估与 TACE 联合 RFA 相比，PBT 治疗不可切除 HCC 的疗效。
我们回顾性分析了 70 例因手术切除或 RFA 单药治疗难以控制的 HCC 患者，其中 24 例接受 PBT 治疗，46 例接受 TACE 联合 RFA 治疗。治疗效果评估为局部无进展生存期（PFS）和总生存期（OS）。
PBT 的局部 PFS 在 60 个月时超过 65%，TACE 联合 RFA 的局部 PFS 在 60 个月时超过 65%。PBT 治疗的患者在 60 个月的治疗后 OS 率为 82%，而 TACE 联合 RFA 治疗的患者 OS 率为 28%。在比较不同慢性肝病严重程度患者的 ALBI 评分变化时，PBT 治疗患者的评分保持在基线水平，而 TACE 联合 RFA 治疗患者的评分在治疗后恶化。
结果表明，与 TACE 联合 RFA 治疗相比，PBT 可能在不可切除 HCC 患者的 OS 方面具有更好的益处，因为它可以保护非肿瘤性肝组织。
