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Transarterial Chemoembolization Versus Proton Beam Radiotherapy for the Treatment of Hepatocellular Carcinoma

Not Applicable
Completed
Conditions
Carcinoma, Hepatocellular
Interventions
Procedure: Transarterial Chemoembolization
Radiation: Proton Beam Radiotherapy
Registration Number
NCT00857805
Lead Sponsor
Loma Linda University
Brief Summary

Patients with liver tumor burden that exceeds Milan criteria are considered to receive one of the following locoregional treatments: transarterial chemoembolization (TACE), radiofrequency ablation (RFA), percutaneous ethanol injection and proton beam radiation (PBR). The goals of these treatments are to control tumor growth, to downstage tumor size to meet Milan criteria, and to improve survival. Patients who exceed the Milan criteria benefit from tumor downstaging as a result of treatment. Patients who meet Milan criteria benefit from tumor control to bridge them to liver transplantation. TACE is considered the most common locoregional treatment that is used to treat hepatocellular carcinoma (HCC). Proton beam radiotherapy has been used in treating HCC in a few centers across the globe. Phase I and II trials showed a satisfactory safety and efficacy results. Loma Linda University Medical Center is one of these pioneering centers that use proton beam as a treatment for HCC. This is the first randomized trial in the medical field that will compare head-to-head the efficacy of TACE versus proton beam in treating HCC patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
76
Inclusion Criteria
  1. Patients are candidates to receive both proton beam and TACE
  2. Patients with no evidence of metastasis or macrovascular invasion
  3. Patients with tumor burden that meets San Francisco criteria
Exclusion Criteria
  1. Patients who are candidates for surgical resection
  2. Patients with lesion < 2 cm
  3. Patients who have contraindication to receive either TACE or proton
  4. Patients with serum alpha fetoprotein > 500
  5. Patients with metastasis or macrovascular invasion
  6. Patients treated previously for HCC by any locoregional treatment
  7. Patients with prior liver transplant
  8. Patients with Child class C
  9. Patients with MELD score of > 25
  10. Patients with other comorbid diseases that may impact survival
  11. Patients with ongoing alcohol intake
  12. Patients with active sepsis
  13. Patients with gastrointestinal bleeding within a week
  14. Patients unwilling to sign informed consent form
  15. Patients with history of noncompliance

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Transarterial ChemoembolizationTransarterial ChemoembolizationTransarterial Chemoembolization
Proton Beam RadiotherapyProton Beam RadiotherapyProton Beam Radiotherapy
Primary Outcome Measures
NameTimeMethod
Two Year Overall Survival24 Months

Comparison between arms of the percentage of patient alive 2 years following study treatment.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Loma Linda University Medical Center

🇺🇸

Loma Linda, California, United States

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