Honda Yohji, Kimura Tomoki, Aikata Hiroshi, Nakahara Takashi, Naeshiro Noriaki, Tanaka Mio, Miyaki Daisuke, Nagaoki Yuko, Kawaoka Tomokazu, Takaki Shintaro, Hiramatsu Akira, Waki Koji, Ishikawa Masaki, Kakizawa Hideaki, Kenjo Masahiro, Awai Kazuo, Nagata Yasushi, Chayama Kazuaki
Hepatogastroenterology. 2014 Jan-Feb;61(129):31-6.
BACKGROUND/AIMS: We retrospectively evaluated the local tumor control and safety of transcatheter arterial chemoembolization (TACE) followed by stereotactic body radiation therapy (SBRT) for small hepatocellular carcinoma (HCC) in this pilot study.
Twenty-eight patients not for the indication of hepatectomy or ablation procedures were enrolled in this study. Eligible criteria was as followed: i) less than 3 hypervascular HCC nodules, each up to 30 mm in diameter; ii) not suitable for the hepatic resection or ablative therapy; iii) Child-Turcotte-Pugh (CTP) score < or = 7. SBRT was performed within 1-2 months after TACE. Treatment efficacy was evaluated, according to the Response Evaluation Criteria in Cancer of the Liver (RECICL).
The median local tumor control time was not reached. The 1-year cumulative local tumor control rate was 96.3%. The median disease-free survival time was 18 months. The 1- year cumulative overall survival rate was 92.6%. One patient (3.6%) died due to intrahepatic ectopic multiple recurrence and systemic metastasis and one (3.6%) due to cerebral hemorrhage. No patients experienced severe acute hematologic or physical toxicity or radiation induced liver damage.
Our study demonstrated SBRT combined with TACE is a safe and effective modality of the locoregional therapy for small primary HCC.
背景/目的：在这项前瞻性研究中，我们回顾性评估了经动脉化疗栓塞术（TACE）联合立体定向体部放射治疗（SBRT）对小肝癌（HCC）的局部肿瘤控制情况及安全性。
本研究纳入了28例不适合肝切除或消融手术的患者。入选标准如下：i）不超过3个富血管性肝癌结节，每个直径最大为30毫米；ii）不适合肝切除或消融治疗；iii）Child-Turcotte-Pugh（CTP）评分≤7。SBRT在TACE后1至2个月内进行。根据《肝癌疗效评价标准》（RECICL）评估治疗效果。
未达到中位局部肿瘤控制时间。1年累积局部肿瘤控制率为96.3%。中位无病生存时间为18个月。1年累积总生存率为92.6%。1例患者（3.6%）因肝内异位多发复发和全身转移死亡，1例（3.6%）因脑出血死亡。无患者出现严重的急性血液学或身体毒性反应或放射性肝损伤。
我们的研究表明，SBRT联合TACE是一种安全有效的小原发性肝癌局部区域治疗方式。
