TITLE:
Proton Beam Therapy for Hepatocellular Carcinoma after the Fontan Procedure
AUTHORS:
Haruko Numajiri, Masashi Mizumoto, Toshiyuki Okumura, Nobuyoshi Fukumitsu, Naoyuki Hasegawa, Kazunori Ishige, Kuniaki Fukuda, Tomoko Ishizu, Katsutoshi Tokushige, Hideyuki Sakurai
KEYWORDS:
Radiotherapy, Proton Beam Therapy, Hepatocellular Carcinoma, Fontan Pro-cedure
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.12 No.10,
October
21,
2021
ABSTRACT: Background: Hepatocellular carcinoma (HCC) is more likely to occur in patients with
a history of Fontan surgery, possibly due to long-term liver congestion. Proton
beam therapy (PBT) may be effective for HCC that develops after Fontan surgery. Methods: Six lesions in 5 patients (3 females, 2 males) received PBT.
The median age of the patients was 33 (range 21 - 42) years, and the median age
at the time of the Fontan procedure was 6 (5 - 13) years. Four patients had
multiple HCC at the time of PBT. The median tumor size was 57 (22 - 80) mm and
4 patients were classified as Child-Pugh B. Two patients received transcatheter
arterial chemoembolization before PBT. The schedule of PBT was 66 Gy (RBE) in
10 fractions for 2 lesions, 72.6 Gy (RBE) in 22 fractions for 2 lesions, and 74
GyE (RBE) in 37 fractions for 2 lesions. Results: The median follow-up
period was 31 (10 - 46) months, and the numbers of survivors, deaths from
primary diseases, and deaths from other diseases were 3, 1, and 1,
respectively. There were no local recurrences, one intrahepatic metastasis, one
lung metastasis, and one intrathoracic metastasis. Conclusion: Although
experiences on a small number of patients cannot conclude things, we believe that PBT can
be a reasonable choice of radical treatment for HCC occurring after the Fontan procedure.