@article{oai:repo.qst.go.jp:00047176,
 author = {柳, 剛 and 安田, 茂雄 and 今田, 浩史 and 山田, 滋 and 加藤, 博敏 and 芝本, 雄太 and 鎌田, 正 and 柳 剛 and 安田 茂雄 and 今田 浩史 and 山田 滋 and 加藤 博敏 and 芝本 雄太 and 鎌田 正},
 issue = {2},
 journal = {Journal of Radiation Oncology},
 month = {Jul},
 note = {Objective
This study aims to assess the usefulness of monitoring serum α-fetoprotein (AFP) levels for predicting recurrence patterns in patients with hepatocellular carcinoma (HCC) treated with carbon-ion radiotherapy.
Methods
Consecutive 157 HCCs treated with definitive carbon-ion radiotherapy between April 1995 and March 2003 were evaluated. Serum AFP levels were measured before and at 3, 6, 12, and 18 months after treatment. Patterns of recurrence were categorized as local (in field), intrahepatic, or distant. Associations between clinical data and onset of recurrence were analyzed. Patients with AFP level of >20 ng/ml were defined as AFP positive.
Results
Follow-up periods were 4.1–66 months (median 35.4 months). Only in the AFP-positive patients, AFP reelevation was associated with the development of recurrence (p = 0.00). Although not statistically significant, patterns of AFP change tended to differ between intrahepatic failure and local failure; AFP levels tended to reelevate earlier in patients developing local failure. Pretreatment AFP of >50 ng/ml (p = 0.00) and total bilirubin of >1.6 mg/dl (p = 0.04) were predictive of development of intrahepatic recurrence within 6 months. AFP of >60 ng/ml (p = 0.00) and platelet of <70,000/mm3 (p = 0.01) were predictive of development of distant metastasis.
Conclusion
AFP monitoring was useful for patients with HCC treated with carbon-ion radiotherapy. Early AFP reelevation was suggestive of in-field local recurrence.},
 pages = {179--184},
 title = {Association between changes in serum α-fetoprotein level and patterns of recurrence in patients undergoing carbon-ion radiotherapy for hepatocellular carcinoma},
 volume = {3},
 year = {2014}
}