HIBMC (2001-2008, R)

Pts with HCC <5 cm

105

52.8 - 76 Gy in 4 - 20 f

Not reported

92.5% at 3 y

49.1% at 5 y

8 G3 acute toxicities

1 G3 late skin****

HIBMC (2001-2009, R)

Pts with IVCTT

16 (13 pts treated with protons, 3 pts treated with carbon ions)

66 Gy in 10 f = 4pts

60 Gy in 10 f = 4 pts

76 Gy in 20 f = 3 pts

76 Gy in 38 f = 1 pt

56 Gy in 8 f = 1 pt

Not reported

100 % at last FUP****

OS = 61.1% at 1 y OS = 36.7% at 3 y****

1 G2 acute hepatic toxicity 2 G2 acute dermatitis 1 G2 late hepatic toxicity (resolved with conservative management)****

HIBMC (2001-2009, R)

Review of all patients treatedin the observation period

242

Various schedules = 76 Gy in 38 f, 56 Gy in 8 f, 60 Gy in 10 f, 76 Gy in 20 f, 66 Gy in 10 f, 80 Gy in 20 f, 84 Gy in 24 f, 52.8 Gy dpf in 4 f

31 m

90.2% at 5 y for all pts 84.1% at 5 y for T ≥ 5 < 10 cm

38% at 5 y for all pts 67.6% at 5 y for BCLC stage 0-A pts 30.6% at 5 y for BCLC stage C pts

≥G3 late toxicities in 8 pts 1 G4 dermatitis 4 G3 dermatitis 1 G3 biloma 1 G3 panniculitis 1 G3 GI ulcer 1RILD

8 G2 rib fractures

NCCHE (1999-2003, P)

CP A-B, max T size = 10 cm, Multinodular HCCs elegible if 1) a single CTV could be created or 2) lesions far from target controlled by other therapies

30

76 Gy in 20 f

31 m (16 - 54)

LPFR = 96 at 2y

OS = 62% at 3 y

DFS 16% at 3 y

8 PHI (4 deaths without recurrence)

1 skin erosion, 1 painful subcutaneous fibrosis

NCCHE (1999-2007, R)

Update of the previous report including patients treated off-protocol

60

Various schedules = 76 Gy in 20 f, 60 Gy in 10 f, 65 Gy in 26 f

43 m

(25 - 92)

LPFS at 3 y = 90% (all pts) LPFS at 5 y = 86% (all pts) LPFS at 3 y for pts receiving 76 Gy vs those receiving 62.5 Gy = 97% vs 56% (P = 0.005) 61% radiological CR 1 to 50 m after PT

OS at 3 y = 56% (all pts)

OS at 5 y = 25% (all pts)

PHI in 11 pts,

all with ICG R15 > 20%, 7 deaths (5 without recurrence)

3 ≥ G2 GI toxicities, 1duodenitis 1colon ulcer, 1esophagitis

LLUMC (1998-2006, P)

Inclusion criteria: <3 lesions, no extra-hepatic spread, no tense ascites

76

63 Gy in 15 f

NA

80% at 5 y

PFS for patients within Milan criteria = 60% at 3y PFS for patients outside Milan criteria = 20% at 3y

70% OS for transplanted pts

5 G2 GI toxicities

No RILD

NCC (2008-2011, R)

Pts with PVTT

27

Various schedules = 50 - 66 Gy in 20-22 f

13.2 m (2.4 - 51.7)

LPFS at 2 y = 61.9%

Median OS = 13 m

No ≥ G3 acute and late toxicities

14.5% 1 point increase in CP score 7% late G2 GI toxicities

MGH (2006-2009, P)

Pilot study of respiratory-gated PT for liver tumors

15 (HCC = 11)*****

Various schedules = 45 - 75 Gy in 15 f

69 m for survivors

100% at last FUP

OS at 3 y = 33%

2 G3 hyperblirubinemia

1 G3 gastrointestinal bleed 1 G5 gastrointestinal perforation