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Purpose This study was conducted to evaluate the safety and efficacy of proton beam therapy for large hepatocellular carcinoma (HCC). Methods Twenty-four patients with a HCC larger than 5.0 cm were treated with proton beam therapy at our institution between 2008 and 2015. Results The clinical stage was I in 2 patients, II in 9 patients and IIIB in 13 patients. Ten of the 24 patients were not surgical candidates because of advanced HCC or old age. Median tumor size was 90 mm (range, 50-180 mm). Median total dose delivered was 72.6 Gray-equivalents (GyE) in 22 fractions (range, 60.8-85.8 GyE). Median follow-up period was 17.5 months (range, 3-70 months). Local control rate at 2 years was 87.0%. The 2-year overall survival rate was 52.4%. The predominant tumor progression pattern was new hepatic tumor development outside the irradiated field. No acute or late treatment-related toxicity of Grade 3 or higher other than dermatitis was observed. Conclusions These results demonstrate that proton beam therapy offers an effective and safe method for treating patients with large HCC. Proton beam therapy represents a promising modality for treatment of large-volume HCC.

Aim The purpose of this study was to clarify the efficacy and toxicities of re-irradiation using proton beam therapy combined with weekly intra-arterial chemotherapy for recurrent oral cancer. Methods Between October 2009 and July 2014, 34 patients who had recurrent oral cancer were treated by proton beam therapy combined with intra-arterial infusion chemotherapy at the Southern Tohoku Proton Therapy Center, Japan. Results For all patients, the median follow-up was 25 months (range, 3–77 months). After treatment, 22 patients (65%) achieved a complete response, and 12 patients (35%) achieved a partial response at the primary tumor site. One-year and 2-year overall survival (OS) rates were 62% and 42%, respectively. One-year and 2-year LC rates were 77% and 60%, respectively. No treatment-related deaths were observed during the treatment and follow-up periods. Conclusion Re-irradiation using proton beam therapy combined with weekly intra-arterial chemotherapy improved OS and local control rates compared with other treatment modalities and could become a new treatment modality for patients with recurrent oral cancer.

Background The purpose of this study was to evaluate the efficacy and toxicities of proton beam therapy combined with intra-arterial infusion chemotherapy via superficial temporal and occipital arteries for recurrent oral cavity squamous cell carcinoma (SCC). Methods Between October 2009 and June 2013, 46 patients with recurrent oral cavity SCC were treated by proton beam therapy combined with intra-arterial infusion chemotherapy of cisplatin (CDDP) and docetaxel. Treatment consisted of proton beam therapy (28.6–74.8 GyE in 13–34 fractions) and intra-arterial infusion chemotherapy (CDDP, 30–50 mg/body/week; docetaxel, 5–25 mg/body/week). Results One-year and 2-year overall survival (OS) rates were 65% and 46%, respectively. One-year and 2-year local control rates were 81% and 70%, respectively. Conclusion These findings suggest that proton beam therapy combined with intra-arterial infusion chemotherapy could be applied effectively and safely for patients with recurrent oral cavity SCC. © 2016 Wiley Periodicals, Inc. Head Neck, 2016

Background We planned a phase I study of weekly arterial infusion of docetaxel and cisplatin via a superficial temporal artery for recurrent head and neck cancer to determine the optimal dose. Methods The dose of cisplatin was fixed and the dose of docetaxel was escalated from 8 mg/m2, with an increase of 2 mg/m2 per step, to identify the maximum tolerated dose (MTD). In total, 4 courses of weekly chemotherapy were administered. Results Twelve patients were recruited to this trial. The MTD of docetaxel was 14 mg/m2. At this dose level, dose-limiting toxicity was observed in 2 of 3 patients. One patient experienced grade 3 leukopenia, while the other experienced grade 3 leukopenia. Myelosuppression was the dose-limiting toxicity for this regimen. Conclusion The recommended dose for weekly arterial infusion of docetaxel was identified as 12 mg/m2 combined with weekly cisplatin at 40 mg/m2, with 4 courses of each. © 2011 Wiley Periodicals, Inc. Head Neck, 2011