Which cancer patients is suitable for proton therapy?

Compared with the high mortality rate, the early detection rate of liver cancer is very low

There are many treatment methods for liver cancer, such as surgery, intervention, and radiotherapy, but the effect is still not very satisfactory

According to statistics from many international proton therapy centers, the 5-year local control rate of proton therapy for liver cancer exceeds 80%

A new choice of radiotherapy for liver cancer-proton therapy 

The essence of proton therapy is radiotherapy, but the difference is that it uses proton rays to accurately irradiate the tumor

Liver cancer is not very sensitive to radiation therapy.

Proton therapy is better than ordinary radiotherapy

Secondly, the Bragg peak is formed when proton rays irradiate the tumor

Comparison of x-ray and proton therapy for liver cancer

X-rays release energy when they reach the human skin

The advantage of proton therapy is that compared with other treatment methods, it can achieve a higher treatment response rate, the tumor control rate is above 90%, and it will not reduce liver function and increase the side effects on the gastrointestinal tract

For early liver cancer, proton therapy has similar results as surgery or percutaneous ablation

 In Japan, where the incidence of liver cancer is also high, the University of Tsukuba has used protons to treat liver cancer patients since 1985

The treatment results showed that the 5-year local control rate (LC) was 86.

In addition, a recent new long-term follow-up by the University of Tsukuba (median follow-up 55 months) showed that the 5-year local control rate (LC) of patients with stage 0/a, B and C were 94%, 87%, and 75%, respectively

This study also confirmed that the results of proton therapy in patients with stage 0/A are similar to the results of partial hepatectomy or percutaneous ablation

For larger liver cancers, proton therapy is more appropriate

If hepatocellular carcinoma (HCC) patients are more likely to develop radiation liver disease after receiving SBRT (stereotactic radiotherapy), proton therapy may be more appropriate

A study treated 22 HCC patients with a median tumor size of 11 cm (10 to 14 cm), with a radiation dose of 72.

Elderly patients with liver cancer are also suitable for proton therapy

A study by the University of Tsukuba included 21 patients with a median age of 81 years (80 to 85 years)

This study confirms that elderly patients can also obtain good therapeutic effects through proton therapy
.

Appropriately increasing the dose of proton therapy can improve the therapeutic effect and prolong survival

In 2005, researchers from Chiba Prefecture, Japan reported that after patients received proton therapy with a median dose of 76 GyE/20 f, 80% of 30 patients achieved complete radiation remission, and the 2-year local control rate (LC) was 96%
.

The Hyogo Prefecture Ion Medicine Center retrospectively analyzed 242 patients who received 8 proton therapy programs (52.
8~84gye /4~38f), the 5-year local control rate (LC) was 90%, and the 5-year overall survival rate (OS) Is 38%
.

Researchers at MD Anderson Cancer Center recently reported the results of a retrospective analysis of 46 patients who received proton therapy with different segmentation schemes, including radiation doses of 58 GyE/15 f and 67.
5 GyE/15 f (56%)
.
They pointed out that for patients with a bioequivalent dose (BED) ≥90 GyE, the median overall survival increased from 15.
8 months to 49.
9 months, indicating a dose-response effect
.