Liver Cancer

Carbon ion radiotherapy for liver cancer

Indications

Carbon ion radiotherapy for liver cancer is performed in the following cases.

	Disease	Indication
1	Hepatocellular carcinoma	Hepatocellular carcinoma that is difficult to treat with conventional curative treatments
2	Intrahepatic bile duct cancer	Unresectable or recurrent intrahepatic bile duct cancer
3	Metastatic liver tumors	Oligometastatic liver tumors (3 or fewer)

Hepatocellular carcinoma is a good indication if there are no lesions other than in the liver and there are not many lesions (approximately 3 or fewer). It may be treatable with carbon ion radiotherapy even if surgery and radiofrequency ablation, the conventional localized treatments, are not indicated for reasons such as the arrangement of the lesions, liver function, or complications. On the other hand, surgery or radiofrequency ablation may be preferable to carbon ion radiotherapy in some cases, such as when the lesion is near the gastrointestinal tract.
In intrahepatic bile duct cancer, carbon ion radiotherapy is indicated if there are no lesions other than in the liver and the lesions are a mass-forming type. Although surgery, the standard treatment, is the first recommendation, intrahepatic bile duct cancer is a good indication for carbon ion radiotherapy if surgery cannot be performed for reasons such as the arrangement of the lesions, liver function, and complications.
For metastatic liver tumors, the requirements are that there are not many tumors (approximately 3 or fewer) and that lesions other than those in the liver are controlled. Other treatments may be recommended depending on the clinical course of the disease to date as well as its current status. Please consult with us first.

Treatment record in QST hospital

	Disease	Period	Number of Patients
1	Hepatocellular carcinoma	2013 to 2017	131
2	Intrahepatic bile duct cancer	2013 to 2017	3
3	Metastatic liver tumors	2013 to 2017	30

In the last 5 years, 131 patients with hepatocellular carcinoma have been treated. A summary of the results for the 133 patients treated from 1997 to 2001 showed that the local control rate (percentage of treated lesions controlled) at 3 years was 90.3%. On the other hand, 3 patients had adverse reactions that required intervention at a certain level (Grade 3). No serious adverse reactions or deaths (Grade 4 or higher) were seen.^*1
For metastatic liver tumors, although no uniform treatment results can be presented due to the variability of the original disease, the 3-year local control rate was 82% in a clinical study in patients with liver tumors metastasized from colorectal cancer who met certain criteria.^*2
Treatment results in intrahepatic bile duct cancer cannot be calculated due to the small number of patients.

*1 Kasuya G, et al. Cancer. 2017; doi: 10.1002/cncr.30816.
*2 Makishima H, et al. Cancer Sci. 2018; doi: 10.1111/cas.13872.