Sanuki Naoko, Takeda Atsuya, Kunieda Etsuo
Naoko Sanuki, Atsuya Takeda, Radiation Oncology Center, Ofuna Chuo Hospital, Kanagawa 247-0056, Japan.
World J Gastroenterol. 2014 Mar 28;20(12):3100-11. doi: 10.3748/wjg.v20.i12.3100.
The integration of new technologies has raised an interest in liver tumor radiotherapy, with literature evolving to support its efficacy. These advances, particularly stereotactic body radiation therapy (SBRT), have been critical in improving local control or potential cure in liver lesions not amenable to first-line surgical resection or radiofrequency ablation. Active investigation of SBRT, particularly for hepatocellular carcinoma (HCC), has recently started, yielding promising local control rates. In addition, data suggest a possibility that SBRT can be an alternative option for HCC unfit for other local therapies. However, information on optimal treatment indications, doses, and methods remains limited. In HCC, significant differences in patient characteristics and treatment availability exist by country. In addition, the prognosis of HCC is greatly influenced by underlying liver dysfunction and treatment itself in addition to tumor stage. Since they are closely linked to treatment approach, it is important to understand these differences in interpreting outcomes from various reports. Further studies are required to validate and maximize the efficacy of SBRT by a large, multi-institutional setting.
新技术的整合引发了对肝脏肿瘤放射治疗的兴趣，相关文献不断发展以支持其疗效。这些进展，尤其是立体定向体部放射治疗（SBRT），对于改善无法进行一线手术切除或射频消融的肝脏病变的局部控制或潜在治愈至关重要。最近已开始对SBRT进行积极研究，特别是针对肝细胞癌（HCC），取得了令人鼓舞的局部控制率。此外，数据表明SBRT有可能成为不适合其他局部治疗的HCC的替代选择。然而，关于最佳治疗指征、剂量和方法的信息仍然有限。在HCC方面，不同国家的患者特征和治疗可及性存在显著差异。此外，HCC的预后除了受肿瘤分期影响外，还受到潜在肝功能障碍和治疗本身的极大影响。由于它们与治疗方法密切相关，因此在解释各种报告的结果时了解这些差异很重要。需要通过大型多机构研究进一步验证并最大化SBRT的疗效。
