Meng Maobin, Wang Huanhuan, Zeng Xianliang, Zhao Lujun, Yuan Zhiyong, Wang Ping, Hao Xishan
Department of Radiation Oncology, CyberKnife Center, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital.
Drug Discov Ther. 2015 Oct;9(5):372-9. doi: 10.5582/ddt.2015.01056.
Hepatocellular carcinoma (HCC) is the most common malignancy in the world and the most common cause of cancer-related death. Surgical resection is the standard of care for solitary liver-confined HCC and provides the best long-term survival, however, most HCCs are diagnosed at an intermediate to advanced stage, and few meaningful therapeutic options are available at this point. Stereotactic body radiation therapy (SBRT) is a type of external beam radiation therapy (EBRT) that delivers radiotherapy (RT) accurately and precisely to the tumor, more so than conventionally fractionated RT. Several series report high rates of local control and low incidence of complications in SBRT for inoperable HCC. Herein, we discuss the emerging role of SBRT as well as current indications, implementation, efficacy and toxicities after SBRT. It was noted that SBRT was a safe and effective therapeutic option for HCC lesions unsuitable for standard locoregional therapies, with acceptable local control rates and low treatment-related toxicity. The significant correlation between local control (LC) and higher doses and between LC and overall survival (OS) supports the clinical value of SBRT in these patients.
肝细胞癌(HCC)是全球最常见的恶性肿瘤,也是癌症相关死亡的最常见原因。手术切除是孤立性肝内局限型HCC的标准治疗方法,可提供最佳的长期生存率。然而,大多数HCC在中晚期才被诊断出来,此时几乎没有有效的治疗选择。立体定向体部放射治疗(SBRT)是一种外照射放疗(EBRT),与传统分割放疗相比,它能更准确、精确地将放射治疗(RT)送达肿瘤部位。多个系列报道显示,SBRT治疗不可切除HCC的局部控制率高,并发症发生率低。在此,我们讨论SBRT的新兴作用以及SBRT后的当前适应证、实施方法、疗效和毒性。值得注意的是,SBRT对于不适合标准局部区域治疗的HCC病变是一种安全有效的治疗选择,具有可接受的局部控制率和较低的治疗相关毒性。局部控制(LC)与较高剂量之间以及LC与总生存期(OS)之间的显著相关性支持了SBRT在这些患者中的临床价值。