Proton Beam Therapy in Managing Unresectable Hepatocellular Carcinoma with Bile Duct Invasion

Hepatocellular carcinoma (HCC) with bile duct invasion is a rare and notorious subtype of HCC. This study included patients that had unresectable HCC with bile duct invasion and proton beam therapy between November 2015 and February 2021. Twenty patients fit the inclusion criteria. The median tumor...

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Published inCancers Vol. 14; no. 7; p. 1616
Main Authors Lee, Ching-Hsin, Chen, An-Hsin, Hung, Sheng-Ping, Hsieh, Cheng-En, Tseng, Jeng-Hwei, Chen, Po-Jui, Cheng, Jen-Yu, Chang, Joseph Tung-Chieh, Chan, Kun-Ming, Lin, Shi-Ming, Lin, Chen-Chun, Chen, Wei-Ting, Chen, Wan-Yu, Huang, Bing-Shen
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 23.03.2022
MDPI
Subjects
Acute toxicity
Bile ducts
Cholangitis
Hepatocellular carcinoma
Liver cancer
Liver diseases
Magnetic resonance imaging
Medical prognosis
Metastasis
Patients
Radiation
Survival
Thrombosis
Tumors
Ulcers
icteric
proton therapy
HCC
hepatic malignancy
liver cancer
bile duct tumor thrombus
biliary tract invasion
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Summary:Hepatocellular carcinoma (HCC) with bile duct invasion is a rare and notorious subtype of HCC. This study included patients that had unresectable HCC with bile duct invasion and proton beam therapy between November 2015 and February 2021. Twenty patients fit the inclusion criteria. The median tumor size was 6.3 cm. Nine patients (45.0%) had major vascular invasions. All included patients received the radiation dose of 72.6 gray relative biological effectiveness due to the proximity of porta hepatis and tumor. The median follow-up time was 19.9 months. The median overall survival was 19.9 months among deceased patients. The 1-year cumulative local recurrence rates were 5.3%, with only two patients developing in-field failure. The 1-year and 2-year overall survival rates were 79.4% and 53.3%. The 1-year progression-free survival was 58.9%. Four patients developed radiation-induced liver disease. The 1-year cholangitis-free survival was 55.0%. Skin toxicity was the most common acute toxicity and rarely severe. Eight patients developed ≤ grade 3 gastrointestinal ulcers. Proton beam therapy offers desirable survival outcomes for unresectable HCC patients with bile duct invasion. Optimal local tumor control could also be obtained within acceptable toxicities.
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ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14071616