肝细胞癌立体定向体部放射治疗期间微小残留肿瘤的临床评估
Clinical Assessment of Micro-residual Tumors during Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma.
作者信息
Uemoto Kenji, Doi Hiroshi, Shiomi Hiroya, Yamada Koichi, Tatsumi Daisaku, Yasumoto Taku, Takashina Masaaki, Koizumi Masahiko, Oh Ryoong-Jin
机构信息
Miyakojima IGRT Clinic, Osaka, Japan
Division of Health Sciences, Osaka University Graduate School of Medicine and Health Science, Suita, Japan.
出版信息
Anticancer Res. 2018 Feb;38(2):945-954. doi: 10.21873/anticanres.12308.
BACKGROUND
This study aimed to assess the need to consider microscopic invasion in terms of treatment planning in stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma and elucidate the appropriate clinical target volume (CTV) margin.
PATIENTS AND METHODS
A total of 121 patients (with 146 liver tumors) who underwent SBRT between July 2007 and August 2016 were analyzed, regarding overall survival and local control (LC).
RESULTS
The 2- and 5-year LC rates were 91.5% and 89.8%, respectively. Planning target volume (PTV) margin <8 mm was associated with poor LC. Of the 77 patients with PTV margin of <8 mm, age <75 years was associated with poor LC, while alpha-fetoprotein (AFP) ≤20 ng/ml was associated with good LC.
CONCLUSION
In patients with high AFP levels, there is a possibility of microscopic invasion around the tumor, suggesting that LC may be improved by adding an additional clinical target volume margin to the gross tumor volume.
背景
本研究旨在评估在肝细胞癌立体定向体部放射治疗（SBRT）的治疗计划中考虑微观侵犯的必要性，并阐明合适的临床靶区（CTV）边界。
患者与方法
分析了2007年7月至2016年8月期间接受SBRT的121例患者（共146个肝肿瘤）的总生存期和局部控制情况。
结果
2年和5年局部控制率分别为91.5%和89.8%。计划靶区（PTV）边界<8 mm与局部控制不佳相关。在77例PTV边界<8 mm的患者中，年龄<75岁与局部控制不佳相关，而甲胎蛋白（AFP）≤20 ng/ml与局部控制良好相关。
结论
在AFP水平较高的患者中，肿瘤周围存在微观侵犯的可能性，这表明通过在大体肿瘤体积基础上增加额外的临床靶区边界，局部控制可能会得到改善。
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