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Objective:To study the efficacy, safety and prognostic factors affecting survival of proton radiation therapy for primary hepatocellular carcinoma (HCC).Methods:Forty-four patients with primary hepatocellular carcinoma treated at Zibo Wanjie Cancer Hospital in Shandong Province from June 15, 2005 to September 12, 2018 were enrolled and given proton radiation therapy with a single dose of 2-5 Gy and a total dose of 25-75 Gy. The overall and local control rates, factors influencing survival, and adverse effects were observed during a follow-up period of 12 to 120 months.Results:The overall survival rates of all patients were 79.5% at 1 year, 68.2% at 2 years, 50.0% at 3 years, and 45.5% at 5 years. The overall local control rate was 95.5%. Patients older than 50 years had a longer overall survival (Log Rank Chi-Square of 4.787, P = 0.029). Child-Pugh A classification had better overall survival compared with B classification (Log Rank Chi-Square 4.077, P = 0.043). The main adverse reactions were skin reactions and gastrointestinal reactions. Among the patients with adverse reactions, 23 patients had skin reactions and 9 patients had mild gastrointestinal reactions, and no serious adverse events were found. Conclusions:Proton radiation therapy has good efficacy and high safety in patients with HCC. Age and Child-Pugh classification are prognostic factors affecting survival after proton radiation therapy.
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Objective To compare the dosimetric difference of proton therapy(PT)and X-ray intensity-modulated radiotherapy(IMRT)for cervical esophageal cancer.Methods The treatment planning of 10 patients with cervical esophageal cancer were selected for this study.One IMRT plan and 2 PT plans (PT1 plan:two opposed AP-PA beams;PT2 plan:two anterior-oblique beams and one posterior beam)were constructed for each patient.The isodose distribution and statistical data extracted from dose volume histograms were used for dose plan comparison.Results The conformal index(CI95%,defined as the ratio between the volume receiving at least 95%of the prescribed dose and the volume of PTV)of IMRT,PT1 and PT2 was 1.43,1.52 and 1.43(F=3.62,P<0.01),respectively.And the mean dose of PTV was 64.4 Gy,65.0 Gy and 63.6 Gy(F=12.06,P<0.01);the mean dose in normal tissue outside of PTV was 20.7 Gy,10.5 Gy and 10.6 Gy(F=77.60,P<0.01),in whole lung was 12.1 Gy,7.3 Gy and 8.4 Gy (F=15.87,P<0.01);the maximum dose in spinal cord was 41.4 Gy,34.9 Gy and 35.0 Gy(F=11.74,P<0.01),respectively.Conclusions Ail plans full file the requirements for PTV,however.PT plans can reduce radiation dose in surrounding normal significantly.The possibility is provided to escalate PT dose in PTV or to combine more aggressive chemotherapy.The PT1 plan full fills the clinical requirements.
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With specific physical characters,proton for postoperative breast cancer can improve dose homogeneity,lower dose to crucial organs such as the heart,lung and the opposite breast,and reduce the complications of normal tissues and incidence of the second primary tumor proton accelerated radiation for partial breast cancer can reduce therapy time,but its long time effect needs great patients and long time follow-up to beproved.