Yamashita Hideomi, Onishi Hiroshi, Matsumoto Yasuo, Murakami Naoya, Matsuo Yukinori, Nomiya Takuma, Nakagawa Keiichi
Department of Radiology, University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Radiat Oncol. 2014 May 10;9:112. doi: 10.1186/1748-717X-9-112.
Stereotactic body radiotherapy (SBRT) is a relatively new treatment for liver tumor. The outcomes of SBRT for liver tumor unfit for ablation and surgical resection were evaluated.
Liver tumor patients treated with SBRT in seven Japanese institutions were studied retrospectively. Patients given SBRT for liver tumor between 2004 and 2012 were collected. Patients treated with SBRT preceded by trans-arterial chemoembolization (TACE) were eligible. Seventy-nine patients with hepatocellular carcinoma (HCC) and 51 patients with metastatic liver tumor were collected. The median biologically effective dose (BED) (α/β = 10 Gy) was 96.3 Gy for patients with HCC and 105.6 Gy with metastatic liver tumor.
The median follow-up time was 475.5 days in patients with HCC and 212.5 days with metastatic liver tumor. The 2-year local control rate (LCR) for HCC and metastatic liver tumor was 74.8% ± 6.3% and 64.2 ± 9.5% (p = 0.44). The LCR was not different between BED10 ≥ 100 Gy and < 100 Gy (p = 0.61). The LCR was significantly different between maximum tumor diameter > 30 mm vs. ≤ 30 mm (64% vs. 85%, p = 0.040) in all 130 patients. No grade 3 laboratory toxicities in the acute, sub-acute and chronic phases were observed.
There was no difference in local control after SBRT in the range of median BED10 around 100 Gy for between HCC and metastatic liver tumor. SBRT is safe and might be an alternative method to resection and ablation.
There was no difference in local control after SBRT in the range of median BED10 around 100 Gy for between HCC and metastatic liver tumor and SBRT is safe and might be an alternative method to resection and ablation.
立体定向体部放疗(SBRT)是一种相对较新的肝肿瘤治疗方法。评估了SBRT治疗不适于消融和手术切除的肝肿瘤的疗效。
回顾性研究了日本7家机构接受SBRT治疗的肝肿瘤患者。收集了2004年至2012年期间接受SBRT治疗的肝肿瘤患者。先行经动脉化疗栓塞术(TACE)后接受SBRT治疗的患者符合条件。收集了79例肝细胞癌(HCC)患者和51例肝转移瘤患者。HCC患者的中位生物等效剂量(BED)(α/β = 10 Gy)为96.3 Gy,肝转移瘤患者为105.6 Gy。
HCC患者的中位随访时间为475.5天,肝转移瘤患者为212.5天。HCC和肝转移瘤的2年局部控制率(LCR)分别为74.8%±6.3%和64.2±9.5%(p = 0.44)。BED10≥100 Gy和<100 Gy之间的LCR无差异(p = 0.61)。在所有130例患者中,最大肿瘤直径>30 mm与≤30 mm之间的LCR有显著差异(64%对85%,p = 0.040)。在急性、亚急性和慢性期均未观察到3级实验室毒性反应。
HCC和肝转移瘤在中位BED10约100 Gy范围内,SBRT后的局部控制无差异。SBRT是安全的,可能是一种替代切除和消融的方法。
HCC和肝转移瘤在中位BED10约100 Gy范围内,SBRT后的局部控制无差异,且SBRT是安全的,可能是一种替代切除和消融的方法。