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<p>Surgical resection or liver transplantation is the cornerstone of curative treatment for hepatoblastoma (HBL). For unresectable HBL, liver transplantation has proven to be a definitive curative option, with long-term survival rates ranging from 30 to 95% in previous studies. However, some patients may not meet the surgical or medical criteria for transplantation. Traditionally, radiotherapy (RT) has not been a standard treatment for HBL due to the risk of high-dose radiation damage to normal liver tissue. Proton beam therapy (PBT), a type of RT, leverages the Bragg peak phenomenon, concentrating the majority of its energy within the last few millimeters of its range. This results in a significantly reduced radiation dose beyond this point, thereby minimizing potential harm to distal radiosensitive structures. PBT has emerged as an alternative treatment option for hepatocellular carcinoma in non-surgical adult patients, but its effects and post-treatment changes in HBL remain under-documented. In this preliminary investigation, we aimed to examine the post-PBT following imaging changes in both HBL and the surrounding liver parenchyma in pediatric patients.<Table Float="No" ID="Taba"> <tgroup align="left" cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> <p><b>What Is Known:</b></p> <p><i>• HBL is the most common primary malignancy of liver in children.</i></p> <p><i>• In HBL, liver transplantation is indicated for patients with tumors that cannot be managed by surgical resection.</i></p> <p><b>What Is New:</b></p> <p><i>• PBT may prove to be a promising treatment option for unresectable HBL, with the potential to preserve normal liver tissue.</i></p> <p><i>• Understanding the imaging changes in post-PBT tumors and the associated focal liver reaction at various time points is crucial for accurately assessing treatment response and guiding appropriate alternative treatment options.</i></p> </entry> </row> </tbody> </tgroup> </Table></p>

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The changes in imaging following proton beam therapy for pediatric hepatoblastoma

  • 期刊论文

  • 发表日期：

    2025年9月19日

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  • Dao-Chen Lin,
  • Jen-Yin Hou,
  • Chen-Kan Tseng,
  • Pei-Shan Tsai

摘要

Surgical resection or liver transplantation is the cornerstone of curative treatment for hepatoblastoma (HBL). For unresectable HBL, liver transplantation has proven to be a definitive curative option, with long-term survival rates ranging from 30 to 95% in previous studies. However, some patients may not meet the surgical or medical criteria for transplantation. Traditionally, radiotherapy (RT) has not been a standard treatment for HBL due to the risk of high-dose radiation damage to normal liver tissue. Proton beam therapy (PBT), a type of RT, leverages the Bragg peak phenomenon, concentrating the majority of its energy within the last few millimeters of its range. This results in a significantly reduced radiation dose beyond this point, thereby minimizing potential harm to distal radiosensitive structures. PBT has emerged as an alternative treatment option for hepatocellular carcinoma in non-surgical adult patients, but its effects and post-treatment changes in HBL remain under-documented. In this preliminary investigation, we aimed to examine the post-PBT following imaging changes in both HBL and the surrounding liver parenchyma in pediatric patients.

What Is Known:

• HBL is the most common primary malignancy of liver in children.

• In HBL, liver transplantation is indicated for patients with tumors that cannot be managed by surgical resection.

What Is New:

• PBT may prove to be a promising treatment option for unresectable HBL, with the potential to preserve normal liver tissue.

• Understanding the imaging changes in post-PBT tumors and the associated focal liver reaction at various time points is crucial for accurately assessing treatment response and guiding appropriate alternative treatment options.