resectable hepatocellular carcinoma
Conditions
Interventions
A: hepatectomy
B: proton beam therapy
Sponsors
Japan Clinical Oncology Group (JCOG)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1) single nodular hepatocellular carcinoma confirmed by dynamic contrast-enhanced CT or MRI of the liver within 28 days 2) cN0M0 diagnosed by dynamic contrast-enhanced CT or MRI of the upper abdomen and X ray or CT of the chest within 28 days 3) new-onset hepatocellular carcinoma 4) the maximum tumor diameter is larger than 3 cm and smaller than 12 cm 5) the margin of the tumor is at least 2 cm or more apart from the gastrointestinal tract 6) no invasion to or tumor thrombosis in the portal vein, the contralateral branches of the portal vein, or the first branch of the portal vein 7) no invasion to or tumor thrombosis in the inferior vena cava, the first branch of the hepatic vein, right inferior hepatic vein, or short hepatic vein 8) no invasion to or tumor thrombosis in the common bile duct or the first branch of the bile duct. 9) completely resectable by left lobectomy, anterior/posterior/lateral segmentectomy, extended subsegmentectomy, subsegmentectomy, or partial resection judged by the qualified surgeon and the cancer board including physicians of hepatobiliary and pancreatic surgery, hepatobiliary and pancreatic medicine, radiation oncology, and diagnostic radiology 10) No previous treatment for HCC 11) No ascites or hepatic encephalopathy 12) Age 20-79 years old 13) ECOG performance status of 0 or 1 14) Adequate organ functions i) White blood cell (WBC) >= 2,000/mm3 ii) Platelet >= 50,000/mm3 iii) Hemoglobin >= 8.0 g/dl iv) Total bilirubin < 2.0 mg/dl v) Serum albumin > 3.5 g/dl vi) Serum creatinine <= 1.5 mg/dl vii) Prothrombin activity > 70% 15) Written informed consent
Exclusion criteria
Exclusion criteria: 1) synchronous or metachronous (within 5 years) malignancy except cancer with 5-year relative survival rate of 95% or more such as carcinoma in situ, intramucosal tumor, or early stage cancers. 2) active infection requiring systemic therapy 3) body temperature >= 38 degrees Celsius 4) female during pregnancy, within 28 days of postparturition, or during lactation 5) severe psychological disorder 6) receiving continuous systemic corticosteroid or immunosuppressant treatment 7) poorly controlled diabetes mellitus or receiving the routine administration of insulin 8) poorly controlled hypertension 9) unstable angina within 3 weeks, or with a history of myocardial infarction within 6 months 10) interstitial pneumonia, pulmonary fibrosis, or severe emphysema on chest CT 11) esophageal varices
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| overall survival | — |
Secondary
| Measure | Time frame |
|---|---|
| progression-free survival, patterns of failure, adverse events, acute non-hematological toxicities of Grade 3 or higher, late adverse reactions of Grade 3 or higher , serious adverse events, Child-Pugh score at 1, 3, and 5 years after the treatment, medical cost, quality of life (QOL), quality adjusted life years (QALY), incremental cost-effectiveness ratio (ICER) | — |
Countries
Japan
Contacts
Public ContactTetsuo Akimoto
JCOG1315 Coordinating Office Division of radiation Oncology and Particle Therapy, National Cancer Center Hospital East
Outcome results
None listed