Clin Mol Hepatol.  2023 Oct;29(4):958-968. 10.3350/cmh.2023.0274.

Current evidence and the potential role of proton beam therapy for hepatocellular carcinoma

• Lee SU
• Kim TH

• KMID: 2546380
• DOI: http://doi.org/10.3350/cmh.2023.0274

Abstract

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death, and external beam radiation therapy has emerged as a promising approach for managing HCC. Proton beam therapy (PBT) offers dosimetric advantages over X-ray therapy, with superior physical properties known as the Bragg peak. PBT holds promise for reducing hepatotoxicity and allowing safe dose-escalation to the tumor. It has been tried in various clinical conditions and has shown promising local tumor control and survival outcomes. A recent phase III trial demonstrated the non-inferiority of PBT in local tumor control compared to current standard radiofrequency ablation in early-stage HCC. PBT also tended to show more favorable outcomes compared to transarterial chemoembolization in the intermediate stage, and has proven effective in-field disease control and safe toxicity profiles in advanced HCC. In this review, we discuss the rationale, clinical studies, optimal indication, and future directions of PBT in HCC treatment.

Keyword

Carcinoma; hepatocellular; Radiotherapy; Proton therapy