Carbon ion radiotherapy in the treatment of hepatocellular carcinoma
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초록
Hepatocellular carcinoma (HCC) is a highly lethal cancer with limited treatment options and poor prognosis. Carbon ion radiotherapy (CIRT) has emerged as a promising treatment modality for HCC due to its unique physical and biological properties. CIRT uses carbon ions to target and destroy cancer cells with a high precision and efficacy. The Bragg Peak phenomenon allows precise dose delivery to the tumor while minimizing damage to healthy tissues. In addition, the high relative biological effectiveness of carbon ions can be shown against radioresistant and hypoxic tumor areas. CIRT also offers a shorter treatment schedule than conventional radiotherapy, which increases patient convenience and compliance. The clinical outcomes of CIRT for HCC have shown excellent local control rates with minimal side effects. Considering its physical and biological properties, CIRT may be a viable option for complex clinical scenarios such as patients with poor liver function, large tumors, re-irradiation cases, and tumors close to critical organs. Further research and larger studies are needed to establish definitive indications for CIRT and to compare its efficacy with that of other treatment modalities. Nevertheless, CIRT offers a potential breakthrough in HCC management, providing hope for improved therapeutic outcomes and reduced treatment-related toxicities.
Abstract
Hepatocellular carcinoma (HCC) is a highly lethal cancer with limited treatment options and poor prognosis. Carbon ion radiotherapy (CIRT) has emerged as a promising treatment modality for HCC due to its unique physical and biological properties. CIRT uses carbon ions to target and destroy cancer cells with a high precision and efficacy. The Bragg Peak phenomenon allows precise dose delivery to the tumor while minimizing damage to healthy tissues. In addition, the high relative biological effectiveness of carbon ions can be shown against radioresistant and hypoxic tumor areas. CIRT also offers a shorter treatment schedule than conventional radiotherapy, which increases patient convenience and compliance. The clinical outcomes of CIRT for HCC have shown excellent local control rates with minimal side effects. Considering its physical and biological properties, CIRT may be a viable option for complex clinical scenarios such as patients with poor liver function, large tumors, re-irradiation cases, and tumors close to critical organs. Further research and larger studies are needed to establish definitive indications for CIRT and to compare its efficacy with that of other treatment modalities. Nevertheless, CIRT offers a potential breakthrough in HCC management, providing hope for improved therapeutic outcomes and reduced treatment-related toxicities.
참고문헌 (48)
- Cronin KA, "Annual report to the nation on the status of cancer, part 1 : National cancer statistics", Cancer, 128, pp.4251~4284 (2022)
- "2020 Cancer Registry Statistics in Korea"[URL]
- Reig M, "BCLC strategy for prognosis prediction and treatment recommendation : The 2022 update", J Hepatol, 76, pp.681~693 (2022)
- 변화경, "Optimal Timing of Radiotherapy after Incomplete Transarterial Chemoembolization for Barcelona Clinic Liver Cancer Stage B Hepatocellular Carcinoma", Yonsei Medical Journal, 62(5), pp.409~416 (2021), 연세대학교의과대학[DOI]
- Jia-Yu Lv, "Comparison of Liver Transplantation and Liver Resection for Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus Type I and Type II", Yonsei Medical Journal, 62(1), pp.29~40 (2021), 연세대학교의과대학[DOI]
- Shiba S, "Comparison of dose distributions when using carbon ion radiotherapy versus intensity-modulated radiotherapy for hepatocellular carcinoma with macroscopic vascular invasion : A retrospective analysis", Anticancer Res, 40, pp.459~464 (2020)
- Lin CA, "Hypoxic microenvironment and hepatocellular carcinoma treatment", Hepatoma Res, 4, pp.26~ (2018)
- Byun HK, "Acute severe lymphopenia by radiotherapy is associated with reduced overall survival in hepatocellular carcinoma", Strahlenther Onkol, 195, pp.1007~1017 (2019)
- Lee BM, "Radiotherapy as an immune checkpoint blockade combination strategy for hepatocellular carcinoma", World J Gastroenterol, 27, pp.919~927 (2021)
- 김용태, "Favorable response of hepatocellular carcinoma with portal vein tumor thrombosis after radiotherapy combined with atezolizumab plus bevacizumab", Journal of Liver Cancer, 23(1), pp.225~229 (2023), 대한간암학회[DOI]
- Seo Hee Choi, "Strategic application of radiotherapy for hepatocellular carcinoma", Clinical and Molecular Hepatology, 24(2), pp.114~134 (2018), 대한간학회
- Apisarnthanarax S, "Proton beam therapy and carbon ion radiotherapy for hepatocellular carcinoma", Semin Radiat Oncol, 28, pp.309~320 (2018)
- Shibuya K, "Short-course carbon-ion radiotherapy for hepatocellular carcinoma : A multi-institutional retrospective study", Liver Int, 38, pp.2239~2247 (2018)
- Fujita N, "Carbon-ion radiotherapy versus radiofrequency ablation as initial treatment for early-stage hepatocellular carcinoma", Hepatol Res, 52, pp.1060~1071 (2022)
- Habermehl D, "Hypofractionated carbon ion therapy delivered with scanned ion beams for patients with hepatocellular carcinoma-feasibility and clinical response", Radiat Oncol, 8, pp.59~ (2013)
- Hiroshima Y, "Clinical impact of carbon-ion radiotherapy on hepatocellular carcinoma with Child-Pugh B cirrhosis", Cancer Med, 12, pp.14004~14014 (2023)
- Hong Z, "Carbon ion radiotherapy with pencil beam scanning for hepatocellular carcinoma : Long-term outcomes from a phase I trial", Cancer Sci, 114, pp.976~983 (2023)
- Imada H, "Compensatory enlargement of the liver after treatment of hepatocellular carcinoma with carbon ion radiotherapy-relation to prognosis and liver function", Radiother Oncol, 96, pp.236~242 (2010)
- Imada H, "Comparison of efficacy and toxicity of short-course carbon ion radiotherapy for hepatocellular carcinoma depending on their proximity to the porta hepatis", Radiother Oncol, 96, pp.231~235 (2010)
- Kasuya G, "Progressive hypofractionated carbon-ion radiotherapy for hepatocellular carcinoma : Combined analyses of 2 prospective trials", Cancer, 123, pp.3955~3965 (2017)
- Kato H, "Results of the first prospective study of carbon ion radiotherapy for hepatocellular carcinoma with liver cirrhosis", Int J Radiat Oncol Biol Phys, 59, pp.1468~1476 (2004)
- Komatsu S, "Clinical results and risk factors of proton and carbon ion therapy for hepatocellular carcinoma", Cancer, 117, pp.4890~4904 (2011)
- Shiba S, "Carbon ion radiotherapy for 80 years or older patients with hepatocellular carcinoma", BMC Cancer, 17, pp.721~ (2017)
- Shiba S, "A comparison of carbon ion radiotherapy and transarterial chemoembolization treatment outcomes for single hepatocellular carcinoma : a propensity score matching study", Radiat Oncol, 14, pp.137~ (2019)
- Shiba S, "No deterioration in clinical outcomes of carbon ion radiotherapy for sarcopenia patients with hepatocellular carcinoma", Anticancer Res, 38, pp.3579~3586 (2018)
- Shiba S, "Clinical impact of Hypofractionated carbon ion radiotherapy on locally advanced hepatocellular carcinoma", Radiat Oncol, 15, pp.195~ (2020)
- Shibuya K, "Efficacy and safety of 4 fractions of carbon-ion radiation therapy for hepatocellular carcinoma : A prospective study", Liver Cancer, 11, pp.61~74 (2021)
- Shibuya K, "A feasibility study of high-dose hypofractionated carbon ion radiation therapy using four fractions for localized hepatocellular carcinoma measuring 3 cm or larger", Radiother Oncol, 132, pp.230~235 (2019)
- Tomizawa K, "Repeated carbon-ion radiation therapy for intrahepatic recurrent hepatocellular carcinoma", Int J Radiat Oncol Biol Phys, 116, pp.1100~1109 (2023)
- Yasuda S, "Long-term results of high-dose 2-fraction carbon ion radiation therapy for hepatocellular carcinoma", Adv Radiat Oncol, 5, pp.196~203 (2019)
- 김지은, "Radiation-induced liver disease: current understanding and future perspectives", Experimental and Molecular Medicine, 49, pp.1~9 (2017), 생화학분자생물학회
- Benedict SH, "Stereotactic body radiation therapy : the report of AAPM Task Group 101", Med Phys, 37, pp.4078~4101 (2010)
- Emami B, "Tolerance of normal tissue to therapeutic irradiation", Int J Radiat Oncol Biol Phys, 21, pp.109~122 (1991)
- Liang SX, "Radiationinduced liver disease in three-dimensional conformal radiation therapy for primary liver carcinoma : the risk factors and hepatic radiation tolerance", Int J Radiat Oncol Biol Phys, 65, pp.426~434 (2006)
- Liang SX, "Dosimetric predictor identification for radiation-induced liver disease after hypofractionated conformal radiotherapy for primary liver carcinoma patients with Child-Pugh Grade A cirrhosis", Radiother Oncol, 98, pp.265~269 (2011)
- Schefter TE, "A phase I trial of stereotactic body radiation therapy(SBRT)for liver metastases", Int J Radiat Oncol Biol Phys, 62, pp.1371~1378 (2005)
- Kuo HT, "Impact of tumor size on outcome after stereotactic body radiation therapy for inoperable hepatocellular carcinoma", Medicine(Baltimore), 96, pp.e9249~ (2017)
- Dawson LA, "Analysis of radiation-induced liver disease using the Lyman NTCP model", Int J Radiat Oncol Biol Phys, 53, pp.810~821 (2002)
- Seror O, "Radiofrequency ablation for the treatment of liver tumors in the caudate lobe", J Vasc Interv Radiol, 16, pp.981~990 (2005)
- Miyayama S, "Hepatocellular carcinoma in the caudate lobe of the liver : variations of its feeding branches on arteriography", Jpn J Radiol, 28, pp.555~562 (2010)
- Lee SU, "Multi-institutional retrospective study of radiotherapy for hepatocellular carcinoma in the caudate lobe", Front Oncol, 11, pp.646473~ (2021)
- Okazaki S, "Carbon ion radiotherapy for patients with hepatocellular carcinoma in the caudate lobe carbon ion radiotherapy for hepatocellular carcinoma in caudate lobe", Hepatol Res, 51, pp.303~312 (2021)
- Lazar AA, "Clinical trials involving carbon-ion radiation therapy and the path forward", Cancer, 124, pp.4467~4476 (2018)
- Shinoto M, "Dosimetric analysis of upper gastrointestinal ulcer after carbon-ion radiotherapy for pancreatic cancer", Radiother Oncol, 120, pp.140~144 (2016)
- 변화경, "Physical and Biological Characteristics of Particle Therapy for Oncologists", Cancer Research and Treatment, 53(3), pp.611~620 (2021), 대한암학회[DOI]
- Kusano Y, "Robust treatment planning in scanned carbon-ion radiotherapy for pancreatic cancer : Clinical verification using in-room computed tomography images", Front Oncol, 12, pp.974728~ (2022)
- Grosshagauer S, "Organs at risk dose constraints in carbon ion radiotherapy at MedAustron : Translations between LEM and MKM RBE models and preliminary clinical results", Radiother Oncol, 175, pp.73~78 (2022)
- Fossati P, "Radiobiological issues in prospective carbon ion therapy trials", Med Phys, 45, pp.e1096~e1110 (2018)
