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• W3094310488 abstract "The efficacy of proton beam therapy (PBT) for cholangio-cellular carcinoma (CCC) has been reported, but insertion of fiducial markers in the liver is usually required. We use a four-dimensional computed tomography (4D-CT) technique to analyze the respiratory motion of target, and enabled respiratory-gated PBT without fiducial marker. We evaluated the efficacy and toxicity of respiratory-gated PBT without fiducial markers for CCC located in the liver. From October 2011 to August 2019 at our institution, 21 lesions in 19 patients were evaluated (median age, 71 years; range, 41-87 years). Ten cases had a pathological diagnosis of CCC. All patients underwent respiratory-gated PBT at a dose of 60 to 83.6 cobalt gray equivalents (CGE) in 20 to 38 fractions with 4D-CT planning. The median tumor size was 50 mm (range, 29-134 mm). In all, 3 patients were positive for hepatitis C virus, 1 for alcoholic liver cirrhosis, 1 for primary biliary cholangitis. All the patients were Child-Pugh A. The median follow-up period was 27months (range, 3-68 months). Local progression was defined as any growth of the irradiated tumor. Toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events ver.5. Local tumor control rate (LC), progression free survival rate (PFS), and overall survival rate (OS) were calculated using the Kaplan-Meier method. The OS rates at 1 and 2 years after PBT were 82% and 61%, respectively. Median survival time (MST) was 38 months for all patients. The PFS rates at 1 and 2 years were 40% and 33%, respectively. The LC rates at 1 and 2 years were 80% and 80%, respectively. Four (20%) patients experienced in-field local failure. Nine (47%) patients had recurrence without local progression; liver metastasis in 7, lymph node metastasis in 5, both of them in 2, liver, lymph node and lung metastasis in 1. Two patients (10.5%) developed a grade 2 pleural effusion. None patients developed treatment-related toxicity > grade 3. The LC rates was not inferior to that of previous reports using fiducial marker. Respiratory-gated PBT for CCC achieves good local control without severe complications." @default.
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• W3094310488 date "2020-11-01" @default.
• W3094310488 modified "2023-09-28" @default.
• W3094310488 title "Respiratory-gated Proton Beam Therapy for CCC without Fiducial Markers" @default.
• W3094310488 doi "https://doi.org/10.1016/j.ijrobp.2020.07.1990" @default.
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