Liver Cancer (Aug 2024)

Particle therapy for intrahepatic cholangiocarcinoma: A multicenter prospective registry study, systematic review and meta-analysis

  • Masashi Mizumoto,
  • Kei Shibuya,
  • Kazuki Terashima,
  • Masao Murakami,
  • Motohiro Murakami,
  • Yoshiyuki Shioyama,
  • Yoshirou Matsuo,
  • Takashi Ogino,
  • Tatsuya Ohno,
  • Takahiro Waki,
  • Hiroyuki Ogino,
  • Hiroyasu Tamamura,
  • Norio Katoh,
  • Masaru Wakatsuki,
  • Tomoaki Okimoto,
  • Motohisa Suzuki,
  • Takashi Saito,
  • Shingo Toyama,
  • Takayuki Hashimoto,
  • Hisateru Ohba,
  • Shoji Kubo,
  • Kiyoshi Hasegawa,
  • Kazushi Maruo,
  • Hideyuki Sakurai

DOI
https://doi.org/10.1159/000540291

Abstract

Read online

Introduction: A prospective study was started in May 2016 to evaluate the efficacy and safety of particle therapy for intrahepatic cholangial carcinoma (ICC). To compare treatment modalities, we also conducted a meta-analysis of literature data and a systematic comparison using registry data. Methods: Patients who received particle therapy for ICC from May 2016 to June 2018 were registered. Nineteen manuscripts (4 particle therapy, 8 3D-CRT, 7 SBRT) were selected for the meta-analysis. Results: A total of 85 cases (proton beam therapy 59, carbon therapy 26) were registered. The median OS of the 85 patients was 22.1 months (95%CI 12.9-31.3); the 1-, 2-, 3- and 4-year OS rates were 70.9% (95% CI 61.1-80.7%), 47.6% (36.8-58.4%), 37.7% (26.7-48.7%), and 22.7% (10.2-35.2%), respectively; and the 1-, 2-, 3- and 4-year local recurrence rates were 8.2% (1.1-15.3%), 21.6% (9.3-33.9%), 33.4% (16.7-50.1%), and 33.4% (16.7-50.1%), respectively. In the meta-analysis and registry data, the 1-year OS for particle therapy, SBRT and 3D-CRT were 71.8% (95% CI 64.6-77.8%), 59.2% (53.0-64.9%, p=0.0573), and 47.2% (36.8-56.9%, p=0.0004), respectively. The incidence of grade 3 or higher late non-hematological toxicity in the meta-analysis and registry data were 7.4-12% for particle therapy, 6.7-16.7% for SBRT, and 8.1-14.3% for 3D-CRT. Conclusions: Particle therapy achieved a good therapeutic effect for ICC, and a meta-analysis indicated that particle therapy is a better treatment modality than SBRT and 3D-CRT.