Abstract 943P
Background
The incidence rate of HCC in the oldest-old (85 years or older) patients is rising along with the global progression of aging society. However, the optimal oncological management of this population has to be elucidated due to the paucity of published studies about very elderly patients. Proton beam therapy (PBT) is a less invasive and effective treatment for HCC. However, long-term outcome of elderly patients underwent PBT for HCC has not been reported. The purpose of our study is to present the outcome and toxicity of PBT for the oldest-old patients with HCC.
Methods
This is a single institutional, retrospective study of 201 elderly patients treated with PBT for HCC from November 2001 to November 2014. Of which, 98 patients (48.8%) were young-old (age: 75-80), 74 (36.8%) were old-old (age: 80-85), and 29 (14.4%) were the oldest-old (age ≥ 85). Overall survival (OS) and progression-free survival (PFS) rates were estimated by Kaplan-Meier method and log-rank test was used for comparisons. Cumulative incidence function (CIF) of local recurrence (LR) was computed by competing risk analysis with death as a competing event. Toxicities were graded according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events version 4.0.
Results
The median follow-up period was 34.9 months. The median age of all patients was 80 (range, 75-92). The median size of a tumor was 3.9 (range, 1.0-15.5) cm. The majority of patients had Eastern Cooperative Oncology Group performance status 0-1 (n=182, 90.6%), solitary tumor (n=145, 72.1%), hepatitis C virus as an underlying cause (n=123, 61.2%), and no previous treatment history (n=106, 52.7%). OS rates at 1, 3, and 5 years were 89.7%, 54.1%, and 32.1%. PFS were 34.4%, 32.9%, 10.5%. At 1, 3, and 5 years, the CIF of LR were 4.7% [1.7-7.6%], 9.6% [5.4-13.9%], and 11.4% [6.8-16.0%], respectively. No significant difference was observed in OS rates between three subgroups (P = 0.4). No grade 3 or worse toxicity was observed.
Conclusions
We observed long-term survival and local control in the oldest-old patients underwent PBT for HCC. Our results indicate that PBT is effective and tolerable for patients with HCC in the oldest-old age.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.