%0 Journal Article
%T Significance of indocyanine green test in radiotherapy for hepatocellular carcinoma
%A Hideyuki Sakurai
%A Masashi Mizumoto
%A Yoshiko Oshiro
%J SCIE-indexed Journal
%D 2019
%R 10.21037/25122
%X Photon radiotherapy was originally not commonly used for hepatocellular carcinoma (HCC) because the large irradiation volume could lead to radiation-induced liver disease (RILD). According to a phase I study by Kim et al., a dose of EQD2 ¡Ý78 GyE10 was necessary to achieve local control. Proton therapy (PT) was initially used only as radical radiotherapy for HCC, but many favorable results of PT for HCC at higher doses have been reported. In a phase II study of PT for HCC, Kawashima et al. found a 2-year local control rate of 96% in 30 patients who received 76 GyE in 20 fractions (1). In another phase II study, Bush et al. observed local failure in only 3 of 76 patients with HCC who received PT at 63 GyE in 15 fractions (2). In a large study performed at the Tsukuba Proton Medical Research Center (3), 266 patients with HCC received PT in three dose-fractionations of 66.0 GyE in 10 fractions, 72.6 GyE in 22 fractions, and 77 GyE in 35 fractions. The 1-, 3- and 5-year local control rates were 98%, 87%, and 81%, respectively, and there was no significant difference among the three protocols (3). A systematic review of PT for HCC by Dionisi et al. suggested that local control was approximately 80% at 3¨C5 years and the average overall survival rate at 5 years was 32%, with data comparable to surgery in the most favorable groups (4)
%U http://tcr.amegroups.com/article/view/25122/html