Kim Jin Suk, Han Kwang Hyub, Lee Do Yun, Seong Jin Sil, Youn Young Hoon, Cheong Jae Youn, Ahn Sang Hoon, Chon Chae Yoon, Moon Young Myoung
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Taehan Kan Hakhoe Chi. 2002 Mar;8(1):71-9.
BACKGROUND/AIMS: Advanced hepatocellular carcinoma with portal vein thrombosis has a poor prognosis. This study was undertaken to evaluate the therapeutic effects of concurrent chemo-radiation therapy in advanced hepatocellular carcinoma with portal vein thrombosis.
A total of 54 patients with advanced hepatocellular carcinoma (TNM stage IVa) were enrolled. Nineteen patients were treated with external beam radiotherapy (4,500 cGy/ 5 weeks) and intrahepatic arterial 5-FU infusion (500 mg on 1-5 day and 30-35 day, respectively) via implanted chemoport. The others were treated with intrahepatic arterial cisplatin infusion (80 mg/m(2)).
In patients treated with concurrent chemo-radiation therapy, response rates at 2nd and 6th months were 42.1% and 26.3%, respectively. In patients treated with intrahepatic arterial cisplatin therapy, response rates at 2nd and 6th months were 2.9% and 0%, respectively. The median survival time was 11.6 months in concurrent chemo-radiation therapy and 4.8 months in intrahepatic arterial cisplatin infusion therapy. Concurrent chemo-radiation therapy produced better response rates and longer survival time than those of intrahepatic arterial cisplatin infusion therapy (p<0.05).
Concurrent chemo-radiation therapy achieved favorable results in advanced hepatocellular carcinoma with portal vein thrombosis and can be considered as a treatment option for the management of advanced hepatocellular carcinoma.
背景/目的：伴有门静脉血栓形成的晚期肝细胞癌预后较差。本研究旨在评估同步放化疗对伴有门静脉血栓形成的晚期肝细胞癌的治疗效果。
共纳入54例晚期肝细胞癌（TNM分期IVa期）患者。19例患者接受外照射放疗（4500 cGy/5周），并通过植入式化疗泵经肝动脉分别在第1 - 5天和第30 - 35天输注5-氟尿嘧啶（500 mg）。其余患者接受肝动脉顺铂输注（80 mg/m²）。
同步放化疗患者在第2个月和第6个月时的缓解率分别为42.1%和26.3%。肝动脉顺铂治疗患者在第2个月和第6个月时的缓解率分别为2.9%和0%。同步放化疗患者的中位生存时间为11.6个月，肝动脉顺铂输注治疗患者为4.8个月。同步放化疗的缓解率和生存时间均优于肝动脉顺铂输注治疗（p<0.05）。
同步放化疗在伴有门静脉血栓形成的晚期肝细胞癌中取得了良好效果，可作为晚期肝细胞癌治疗的一种选择。
