肝细胞癌门静脉瘤栓的适形放射治疗

Conformal radiation therapy for portal vein tumor thrombosis of hepatocellular carcinoma.

作者信息

Toya Ryo, Murakami Ryuji, Baba Yuji, Nishimura Ryuichi, Morishita Shoji, Ikeda Osamu, Kawanaka Koichi, Beppu Toru, Sugiyama Shinichi, Sakamoto Takashi, Yamashita Yasuyuki, Oya Natsuo

机构信息

Department of Radiation Oncology, Kumamoto University Hospital, Honjo, Kumamoto, Japan.

出版信息

Radiother Oncol. 2007 Sep;84(3):266-71. doi: 10.1016/j.radonc.2007.07.005. Epub 2007 Aug 22.

DOI:10.1016/j.radonc.2007.07.005

PMID:17716760

Abstract

BACKGROUND AND PURPOSE

The prognosis of patients with portal vein tumor thrombosis (PVTT) from hepatocellular carcinoma (HCC) is poor; without treatment, their survival is less than 3months. We retrospectively evaluated the treatment outcomes of conformal radiation therapy (CRT) in patients with HCC-PVTT.

MATERIALS AND METHODS

Thirty-eight HCC patients with PVTT in whom other treatment modalities were not indicated underwent CRT. The total dose was translated into a biologic effective dose (BED) of 23.4-59.5Gy(10) (median 50.7Gy(10)) as the alpha/beta ratio=10. Predictive factors including the age, performance status, Child-Pugh classification, PVTT size, and BED were evaluated for tumor response and survival.

RESULTS

Complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) were observed in 6 (15.8%), 11 (28.9%), 17 (44.7%), and 4 (10.5%) patients, respectively. The response rate (CR+PR) was 44.7%. The PVTT size (<30 vs. 30mm) and BED (<58 vs. 58Gy(10)) were significant factors for tumor response. The median survival and 1-year survival rate were 9.6months and 39.4%. The Child-Pugh classification (A vs. B) and BED were significant factors for survival.

CONCLUSIONS

CRT is effective not only for tumor response but also for survival in HCC-PVTT patients in whom other treatment modalities are not indicated.

摘要

背景与目的

肝细胞癌（HCC）合并门静脉癌栓（PVTT）患者的预后较差；未经治疗，其生存期不足3个月。我们回顾性评估了适形放疗（CRT）对HCC-PVTT患者的治疗效果。

材料与方法

38例HCC合并PVTT且不适合其他治疗方式的患者接受了CRT。总剂量转换为生物等效剂量（BED），范围为23.4-59.5Gy(10)（中位数50.7Gy(10)），α/β比值=10。评估包括年龄、体能状态、Child-Pugh分级、PVTT大小和BED等预测因素对肿瘤反应和生存的影响。

结果

分别有6例（15.8%）、11例（28.9%）、17例（44.7%）和4例（10.5%）患者出现完全缓解（CR）、部分缓解（PR）、疾病稳定（SD）和疾病进展（PD）。缓解率（CR+PR）为44.7%。PVTT大小（<30 vs. 30mm）和BED（<58 vs. 58Gy(10)）是影响肿瘤反应的重要因素。中位生存期和1年生存率分别为9.6个月和39.4%。Child-Pugh分级（A vs. B）和BED是影响生存的重要因素。