Michel Rives, Françoise Izar, Laure Parent, Anouchka Modesto, Guillaume Portier, Sylvain Kirzin
Institut Claudius Regaud, 1 avenue Irène Joliot-Curie, 31059 Toulouse Cedex, France.
Department of Digestive Surgery, Purpan University Hospital, Toulouse, France.
Rep Pract Oncol Radiother. 2017 Mar-Apr;22(2):96-102. doi: 10.1016/j.rpor.2017.03.001. Epub 2017 Apr 17.
Stereotactic body radiation therapy (SBRT) is delivered in a curative intent to many primary and secondary tumors. Concerning liver metastasis, SBRT can be safely delivered using one to five fractions. An excellent local control is obtained with doses from 20 to 60 Gy. For primary hepatic tumors, results are also good, but the risk of hepatic toxicity related to liver pre-existent pathology must be taken into account. Radiation induced liver disease (RILD) is not frequent in its classical presentation, but modifications of liver enzymes are often observed. Other toxicities of SBRT on the duodenum, small bowel and biliary tract are also described. With respect to contraindications and dose limitations on surrounding structures, SBRT is well tolerated and takes place among curative treatment of liver tumors, as surgery, radiofrequency and embolization.
立体定向体部放射治疗（SBRT）以治愈为目的应用于多种原发性和继发性肿瘤。对于肝转移瘤，SBRT可安全地采用1至5次分割照射。给予20至60 Gy的剂量可获得良好的局部控制。对于原发性肝肿瘤，结果也较好，但必须考虑与肝脏既往病变相关的肝毒性风险。放射性肝病（RILD）的典型表现并不常见，但经常观察到肝酶的改变。还描述了SBRT对十二指肠、小肠和胆道的其他毒性。关于周围结构的禁忌症和剂量限制，SBRT耐受性良好，在肝肿瘤的根治性治疗中，如手术、射频和栓塞治疗中占有一席之地。
