Abstract
PURPOSE: The local treatment strategy for fragile patients with hepatocellular carcinoma (HCC) with Child-Pugh class B (CP-B) remains unclear. In this study, we evaluated the safety and efficacy of carbon-ion radiation therapy (CIRT) for HCC with CP-B. METHODS AND MATERIALS: Fifteen consecutive patients with HCC with CP-B who received CIRT between March 2017 and June 2023 were analyzed. Survival and local control probabilities were calculated using the Kaplan-Meier method. Treatment-related liver toxicities were defined as a ≥2-point increase in CP score within 6 months of CIRT. RESULTS: The median follow-up duration after CIRT was 18.7 months. The median age of patients at the time of registration for CIRT was 71 years. The median tumor size was 51 mm. Eleven patients had a CP score of 7, 3 had a score of 8, and 1 had a score of 9. The number of patients with treatment-naïve and recurrent HCC was 6 and 9, respectively. The 1- and 2-year overall survival rates were 67% and 50%, respectively. The 1- and 2-year local control rates were both 94%. The 1- and 2-year progression-free survival rates were 67% and 11%, respectively. Four patients (27%) experienced treatment-related liver toxicities. No patient developed grade 3 or higher toxicities during the acute and late phases. CONCLUSIONS: Overall, this study showed the safety and efficacy of CIRT for HCC with CP-B. CIRT is a local treatment option for HCC with CP-B.