Eun Hyuk Soo, Kim Min Jung, Kim Hye Jin, Ko Kwang Hun, Moon Hee Seok, Lee Eaum Seok, Kim Seok Hyun, Lee Heon Young, Lee Byung Seok
Division of Gastroenterology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
Korean J Hepatol. 2011 Sep;17(3):189-98. doi: 10.3350/kjhep.2011.17.3.189.
BACKGROUND/AIMS: This study was conducted to investigate the assessment of treatment efficacy of radiotherapy (RT) and other therapeutic modalities compared with palliative care only for treatment with advanced hepatocellular carcinoma (HCC).
From 2002 to 2010, based on the case of 47 patients with advanced HCC, we have investigated each patients' Child-Pugh's class, ECOG performance, serum level of alpha fetoprotein and other baseline characteristics that is considered to be predictive variables and values for prognosis of HCC. Out of overall patients, the 29 patients who had received RT were selected for one group and the 18 patients who had received only palliative care were classified for the other. The analysis in survival between the two groups was done to investigate the efficacy of RT.
Under the analysis in survival, the mean survival time of total patients group was revealed between 30.1 months and 45.9 months in RT group, while it was 4.8 months in palliative care group, respectively. In the univariate analysis for overall patients, there were significant factors which affected survival rate like as follows: ECOG performance, Child-Pugh's class, the tumor size, the type of tumor, alpha fetoprotein, transarterial chemoembolization, and RT. The regressive analysis in multivariate Cox for total patients. No treatment under radiotherapy and high level of Child-Pugh's class grade were independent predictors of worse overall survival rate in patients. In contrast, for the subset analysis of the twenty-nine patients treated with radiotherapy, the higher serum level of alpha fetoprotein was an independent predictors of worse overall survival rate in patients.
We found that the survival of patients with advanced HCC was better with radiotherapy than with palliative care. Therefore, radiotherapy could be a good option for in patients with advanced HCC.
背景/目的：本研究旨在调查与仅采用姑息治疗相比，放射治疗（RT）及其他治疗方式对晚期肝细胞癌（HCC）的治疗效果评估。
2002年至2010年，基于47例晚期HCC患者的病例，我们调查了每位患者的Child-Pugh分级、东部肿瘤协作组（ECOG）体能状态、甲胎蛋白血清水平以及其他被视为HCC预后预测变量和预后值的基线特征。在所有患者中，将接受RT的29例患者分为一组，将仅接受姑息治疗的18例患者分为另一组。对两组患者的生存情况进行分析以研究RT的疗效。
在生存分析中，RT组所有患者的平均生存时间为30.1个月至45.9个月，而姑息治疗组为4.8个月。在对所有患者的单因素分析中，影响生存率的显著因素如下：ECOG体能状态、Child-Pugh分级、肿瘤大小、肿瘤类型、甲胎蛋白、经动脉化疗栓塞和RT。对所有患者进行多变量Cox回归分析。放疗下未接受治疗和Child-Pugh分级高是患者总体生存率较差的独立预测因素。相比之下，对接受放疗的29例患者进行亚组分析，较高的甲胎蛋白血清水平是患者总体生存率较差的独立预测因素。
我们发现晚期HCC患者接受放疗的生存率高于姑息治疗。因此，放疗可能是晚期HCC患者的一个不错选择。
