Hepatocellular carcinoma is the most prevalent type of liver cancer. It occurs more often in men than women and is commonly seen in people between the ages of 50 and 60 years old. Having cirrhosis, hepatitis B and hepatitis C increases one’s risk of developing liver cancer. Aggressive surgery or a liver transplant has been the successful approach to treating small or slow growing lesions that are diagnosed early. Chemotherapy and radiation are not effective treatments. These treatments are used to reduce the size of a tumor and increase the success rate of surgery.
The recently-presented research of Zeid Kayali, M.D. and fellow researchers from Loma Linda University Medical Center in California finds that proton beam radiation therapy is safe and effective treatment for advanced and inoperable liver cancer. To date, this is the largest trial of the use of this type of radiation therapy on liver tumors in patients who have cirrhosis.
There were 18 individuals who received 15 treatments over a three week period. The largest tumor in this study was 10 cm or four inches in size. The average tumor size was 5.5 cm or about two-and-a-half inches. The participants in the study all received liver transplants following this treatment. Of the group, there was no sign of residual tumor in six patients, seven patients had microscopic evidence of residual tumor, and five had major residual tumor of the liver.
Proton beam radiation allows the delivery of high doses of radiation to the tumor while sparing the surrounding healthy tissue.
Attendees of the European Association for the Study of the Liver 45th Annual Meeting, at which this study was presented, raised concern about cost and availability. Medicare and Medicaid do not reimburse for proton beam radiation therapy. Availability of equipment for proton beam radiation is limited. Mark Thursz, MD, professor of hepatology at Imperial College London in the United Kingdom commented, "I think there were some biases in the way the patients were selected in the study. They treated patients who perhaps should have been treated in other ways. It wasn't a randomized trial."
Article sources: www.medscape.com