Liver Neoplasm Clinical Trial
The standard treatment of unresectable hepatocellular carcinoma (HCC) is transarterial
chemoembolization (TACE) or sorafenib. Though the TACE and the agent showed survival benefit
in several randomized phase III trials, the benefit was modest.
Recently, radiotherapy (RT), especially conformal and higher dose with the advancement of RT
techniques, showed favorable response rate with acceptable local control rate. Based on those
promising results, RT was actively applied in HCC who are not indicated with surgery and/or
radiofrequency ablation.
Many researchers reported that there is a relationship between RT dose and tumor response
rate. RT dose, however, is frequently limited because the complications (like radiation
induced liver disease (RILD), radiation induced gastro-duodenal toxicity, etc.) are also
closely related with higher exposed RT dose.
Proton beam has characteristic depth-dose distribution contrast to photon, the "Bragg peak".
The advantage of this dose distribution could be more highlighted in HCC management, because
of the weakness and maintenance importance of liver function itself in HCC patients. In fact,
the superior results of proton beam therapy in HCC were constantly reported in several groups
as prospectively as well as retrospectively.
In this background, the investigators planned the present study to evaluate the efficacy and
safety of proton beam therapy in HCC patients who are not indicated with surgery and/or
radiofrequency ablation (RFA).
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