Goyal K, Einstein D, Yao M, Kunos C, Barton F, Singh D, Siegel C, Stulberg J, Sanabria J
Department of Surgery, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA.
HPB Surg. 2010;2010. doi: 10.1155/2010/309780. Epub 2010 Jun 28.
Stereotactic body radiation therapy (SBRT) has emerged as a treatment option for local tumor control of primary and secondary malignancies of the liver. We report on our updated experience with SBRT in patients with non-resectable tumors of the liver.
Our first 17 consecutive patients (mean age 58.1 years) receiving SBRT for HCC (n = 6), IHC (n = 3), and LM (n = 8) are presented. Mean radiation dose was 34 Gy delivered over 1-3 fractions.
Treated patients had a mean decrease in maximum pretreatment tumor diameter from 6.9 +/- 4.6 cm to 5.0 +/- 2.1 cm at three months after treatment (P < .05). The mean total tumor volume reduction was 44% at six months (P < .05). 82% of all patients (14/17) achieved local control with a median follow-up of 8 months. 100% of patients with HCC (n = 6) achieved local control. Patients with surgically placed fiducial markers had no complications related to marker placement.
Our preliminary results showed that SBRT is a safe and effective local treatment modality in selected patients with liver malignancies with minimal adverse events. Further studies are needed to define its role in the management of these malignancies.
立体定向体部放射治疗（SBRT）已成为一种用于肝脏原发性和继发性恶性肿瘤局部肿瘤控制的治疗选择。我们报告了我们在不可切除肝脏肿瘤患者中使用SBRT的最新经验。
介绍了我们连续收治的首批17例接受SBRT治疗的患者（平均年龄58.1岁），其中肝癌（HCC）6例、肝内胆管癌（IHC）3例、肝转移瘤（LM）8例。平均放射剂量为34 Gy，分1 - 3次给予。
治疗后3个月，治疗患者的最大治疗前肿瘤直径平均从6.9±4.6 cm降至5.0±2.1 cm（P <.05）。6个月时平均总肿瘤体积缩小44%（P <.05）。所有患者中有82%（14/17）实现了局部控制，中位随访时间为8个月。肝癌患者（n = 6）100%实现了局部控制。手术放置基准标记物的患者未发生与标记物放置相关的并发症。
我们的初步结果表明，SBRT是一种安全有效的局部治疗方式，适用于部分肝脏恶性肿瘤患者，不良事件最少。需要进一步研究来确定其在这些恶性肿瘤治疗中的作用。
