Hepatology and Liver Transplant Medicine Unit, Flinders Medical Centre, Adelaide, South Australia, Australia.
J Gastroenterol Hepatol. 2010 Apr;25(4):664-71. doi: 10.1111/j.1440-1746.2009.06126.x. Epub 2010 Jan 14.
External beam radiotherapy currently has a limited role in the treatment of hepatocellular carcinoma (HCC). The purpose of this article was to review available radiobiological data on HCC and normal liver and incorporate these data into radiobiological models that may be used to explain and improve treatment.
Volume doubling times of HCC were described and used to demonstrate growth of HCC with time, assuming both exponential and logistic growth. Radiosensitivity of HCC was described and used to demonstrate the probability of uncomplicated tumor control as tumor size increases. The relationship between tolerance of liver to irradiation and volume irradiated was examined.
The median volume doubling time for untreated HCC was 130 days. HCC have a long period of subclinical growth. Radiosensitivity of HCC lies within the range of other tumors commonly treated with radiotherapy. When treating small volumes of normal liver, relatively high doses may be used with low risk of late radiation damage. There is a high probability of sterilizing subclinical disease and small HCC with tolerable radiation doses.
New radiobiological data, modeling, emerging clinical data and the advantages offered by standard external beam radiotherapy techniques suggest the need for reconsidering the use of radiotherapy and for new trials.
目前，外照射放疗在肝细胞癌（HCC）治疗中的作用有限。本文旨在回顾 HCC 和正常肝脏的现有放射生物学数据，并将这些数据纳入放射生物学模型，以解释和改善治疗效果。
描述 HCC 的体积倍增时间，并假设 HCC 呈指数和逻辑增长，以此来展示 HCC 的随时间生长。描述 HCC 的放射敏感性，并展示随着肿瘤体积增大，无并发症肿瘤控制的概率。检查肝脏对照射的耐受能力与照射体积之间的关系。
未经治疗的 HCC 的中位体积倍增时间为 130 天。HCC 具有较长的亚临床生长期。HCC 的放射敏感性在其他常用放疗治疗的肿瘤范围内。当治疗小体积的正常肝脏时，相对高剂量可能具有低晚期辐射损伤风险。用可耐受的辐射剂量，有很大的概率能杀灭亚临床疾病和小 HCC。
新的放射生物学数据、建模、新兴的临床数据以及标准外照射放疗技术提供的优势，表明需要重新考虑放疗的应用，并进行新的试验。
