老年肝细胞癌患者立体定向体部放疗的临床疗效
Clinical outcomes of stereotactic body radiotherapy for elderly patients with hepatocellular carcinoma.
作者信息
Teraoka Yuji, Kimura Tomoki, Aikata Hiroshi, Daijo Kana, Osawa Mitsutaka, Honda Fumi, Nakamura Yuki, Morio Kei, Morio Reona, Hatooka Masahiro, Kobayashi Tomoki, Nakahara Takashi, Murakami Eisuke, Nagaoki Yuko, Kawaoka Tomokazu, Tsuge Masataka, Hiramatsu Akira, Imamura Michio, Kawakami Yoshiiku, Nagata Yasushi, Chayama Kazuaki
机构信息
Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Department of Radiation Oncology and Diagnostic Radiology, Hiroshima University, Hiroshima, Japan.
出版信息
Hepatol Res. 2018 Feb;48(2):193-204. doi: 10.1111/hepr.12916. Epub 2017 Jun 24.
AIM
To evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for the treatment of hepatocellular carcinoma (HCC) in elderly patients.
METHODS
From 2008 to 2015, 117 patients with HCC (≤3 nodules, ≤30 mm in diameter, Child-Pugh score ≤7, and no vascular or extracellular metastasis) were treated with SBRT at our hospital. We evaluated overall survival (OS), disease-free survival (DFS), local control, and adverse events. Patients were stratified according to age 75 years and older (elderly group, n = 54) and age younger than 75 years (young group, n = 63).
RESULTS
The median OS in the elderly group was not significantly different from that in the young group (52 months vs. not reached, P = 0.27). The 1-, 2-, and 3-year OS rates were 96.2%, 77.6%, and 63.9%, respectively, in the elderly group, and 96.8%, 84.8%, and 67.7%, respectively, in the young group. The median DFS in the elderly group was significantly shorter than that in the young group (13 vs. 25 months, respectively; P = 0.03). The 1-, 2-, and 3-year DFS rates were 50.6%, 30.4%, and 26.6%, respectively, in the elderly group and 66.5%, 50.7%, and 45.3%, respectively, in the young group. The 3-year local tumor control rate in the elderly group was 98.1%, and that in the young group was 98.4% (P = 0.83). There was no difference between groups in the incidence of any adverse events.
CONCLUSIONS
Stereotactic body radiotherapy can be effective and safe for the treatment of HCC in elderly patients.
目的
评估立体定向体部放疗（SBRT）治疗老年肝细胞癌（HCC）患者的安全性和有效性。
方法
2008年至2015年，我院对117例HCC患者（结节≤3个，直径≤30 mm，Child-Pugh评分≤7，无血管或远处转移）进行了SBRT治疗。我们评估了总生存期（OS）、无病生存期（DFS）、局部控制情况和不良事件。患者按年龄分为75岁及以上（老年组，n = 54）和75岁以下（年轻组，n = 63）。
结果
老年组的中位OS与年轻组无显著差异（52个月 vs. 未达到，P = 0.27）。老年组1年、2年和3年的OS率分别为96.2%、77.6%和63.9%，年轻组分别为96.8%、84.8%和67.7%。老年组的中位DFS显著短于年轻组（分别为13个月和25个月；P = 0.03）。老年组1年、2年和3年的DFS率分别为50.6%、30.4%和26.6%，年轻组分别为66.5%、50.7%和45.3%。老年组的3年局部肿瘤控制率为98.1%，年轻组为98.4%（P = 0.83）。两组间任何不良事件的发生率无差异。
结论
立体定向体部放疗治疗老年HCC患者有效且安全。
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