Proton Stereotactic Body Radiation Therapy for Carcinoma, Hepatocellular

To summarize, although the tumor size and the degree of hepatic function are of great significance for the prognosis and survival of HCC patients, the BCLC staging system has been proven to be still a good surrogate in predicting overall survival after TACE treatment.

[Chronic hepatitis (CH) and alcoholic cirrhosis (AC) are often associated with [hepatocellular carcinoma] (HCC). HCC is a main cause of death in CH and AC patients. HCCs should be considered as a new entity and should receive higher priority when planning treatment in chronic hepatitis patients.

Approximately 713200 cases of carcinoma, hepatocellular occur each year in the United States. However, many of these cases do not develop into cancer. Therefore, in the United States, only a very small proportion of carcinoma, hepatocellular is the product of the initiation process alone. Most cases are the consequence of other factors not currently under my investigation.

For a selected group of patients with localized HCC that were amenable to either surgical resection or ablation, combined modality therapy such as chemotherapy before or during hepatectomy has shown benefit in terms of overall survival and recurrence-free survival. Although radiation therapy can be used as part of neoadjuvant therapy and/or adjuvant therapy after curative hepatectomy, a recent phase III study by the American Joint Committee on Cancer (AJCC) revealed no significant difference in overall cancer-specific survival (CSSS) or disease-free survival between the use of post-surgery postoperative radiotherapy versus only post-surgery chemotherapy for HCC after curative surgery.

The signs and symptoms of carcinoma (especially HCC) are similar to those of chronic viral hepatitis and cirrhosis. These include fatigue, malaise, weight loss, anemia, abdominal pain, hepatomegaly, fever, and leukocytosis. The underlying mechanisms of these signs are usually due to secondary infections.

Although various infectious agents can cause hepatocarcinogenesis, no single agent has been identified. The identification of environmental factors that promote hepatocarcinogenesis is crucial to the development of strategies to halt/reverse its occurrence.

Stereotactic body radiation treatments are rapidly expanding into a full suite of specialized proton beam treatments. This technology offers treatment options, and potential improvements in patient selection, dose escalation, tumor response and tolerability.

Survival and recurrence of HCC is poor after curative treatments, whereas it is relatively lower in the case of cirrhotic patients. The underlying underlying mechanism may be due to liver tumor growth or the infiltration of cancerous cells into the portal vein. [Hepatocellular carcinoma is one of the leading cancers in terms of prevalence and mortality among the noncommunicable diseases in China. In the last 40 years, the incidence of HCC has steadily increased, but the prognosis of patients is still very poor. The mortality rate can be up to 70%.] Given the high prevalence of cirrhosis in China, HCC tends to become highly prevalent in a population.

The high-risk patient group should be the prime target for clinical trials. Patient selection and careful inclusion criteria will enhance quality of life and survival.

The authors' results are consistent with the earlier published results of two previous studies. The earlier studies are at better quality, however, all three are consistent with conclusions from studies published previously.

Infectious and non-infectious causes for HCC have been described. The most common, if not the only, cause of HCC is chronic HBV infection (70%). Other known risk factors for HCC include a history of cirrhosis (5.4%) from HBV, HCV, or alcohol use (2.7%); and alcohol use alone (3.9%).