Adverse Events After Carbon-Ion Radiotherapy (CIRT) for Hepatocellular Carcinoma and Risk Factors for Biliary...

Area of Science:

• Oncology
• Radiotherapy
• Hepatobiliary Medicine

Background:

• Hepatocellular carcinoma (HCC) management often involves radiotherapy.
• Carbon-ion radiotherapy (CIRT) is an advanced treatment modality for HCC.
• Understanding adverse events (AEs) and specific complications like biliary stricture post-CIRT is crucial.

Purpose of the Study:

• To investigate the timing and nature of AEs following CIRT for HCC.
• To identify risk factors associated with biliary stricture after CIRT.
• To analyze AE grading and patient characteristics.

Main Methods:

• Retrospective analysis of 103 HCC patients treated with CIRT (60 Gy/4 fractions).
• Detailed assessment of AE onset, frequency, and grade.
• Classification of HCC into perihilar and distal types to evaluate biliary stricture risk factors.

Main Results:

• AEs were more common in patients with liver dysfunction, dermatitis, and pigmentation.
• Biliary stricture occurred months after CIRT (3.0-17.0 months) and was exclusively seen in perihilar HCC.
• Perihilar HCC with tumors near portal vein branches, macrovascular invasion, and prior perihilar therapy increased biliary stricture risk.

Conclusions:

• CIRT for HCC can lead to AEs, with biliary stricture being a significant late complication.
• Perihilar tumor location, portal vein involvement, and prior treatments are key risk factors for biliary stricture post-CIRT.
• This study provides essential data on CIRT AEs and biliary stricture risks in HCC.