Exploratory case series of conversion to carbon ion radiotherapy after systemic therapy in advanced hepatocellular carcinoma
Abstract
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with advanced cases often presenting macrovascular invasion (MVI) or extrahepatic spread (EHS), limiting curative options. Latest systemic therapies, such as atezolizumab plus bevacizumab, have demonstrated potential in converting advanced HCC into treatable states. Carbon ion radiotherapy (C-ion RT), with its superior dose localization and biological effectiveness, has emerged as a promising treatment for advanced HCC. This retrospective exploratory case series reviewed eight patients with advanced HCC who received C-ion RT following systemic therapy at a single Japanese institution between 2021 and 2023. Data collection and follow-up were completed in October 2024. During the study period, 188 patients with advanced HCC received systemic therapy at our institution. Among these, 176 patients (93.6%) continued systemic therapy alone or received additional transarterial chemoembolization (TACE) for local disease control, while 12 patients (6.4%) were evaluated for curative-intent local therapy through multidisciplinary discussion. Patients were considered for conversion therapy after showing tumor shrinkage or loss of contrast enhancement during systemic therapy, but surgical resection was judged infeasible due to poor liver function or surgical tolerance. Therefore, C-ion RT was selected to treat all residual intrahepatic lesions. Clinical characteristics, treatment details, radiological…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 188 participants or records.
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