对于直径 3cm 或更大的局限性肝细胞癌，采用四分次大剂量分割碳离子放射治疗的可行性研究。
A feasibility study of high-dose hypofractionated carbon ion radiation therapy using four fractions for localized hepatocellular carcinoma measuring 3 cm or larger.
机构信息
Gunma University Heavy Ion Medical Center, Maebashi, Japan; Department of Radiation Oncology, Gunma University Hospital, Maebashi, Japan.
Gunma University Heavy Ion Medical Center, Maebashi, Japan.
出版信息
Radiother Oncol. 2019 Mar;132:230-235. doi: 10.1016/j.radonc.2018.10.009. Epub 2018 Oct 23.
BACKGROUND AND PURPOSE
To evaluate the safety of carbon-ion radiotherapy (C-ion RT) using 60 Gy (relative biological effectiveness, RBE) in four fractions for patients with hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
The primary outcome was acute toxicities within 90 days. The secondary outcomes were late toxicities, local control, and progression-free survival and overall survival rates. The key inclusion criteria were as follows: (1) 3 cm or larger HCC without major vascular invasion and not adjacent to the alimentary tract; (2) Child-Pugh's grade A/B; and (3) without extrahepatic metastasis.
RESULTS
A total of 21 cases were analyzed between October 2012 and April 2016. The median follow-up period among the 17 survivors was 24.2 (range: 6.3-43.7) months. Grade 3 or higher acute toxicity was not observed, while three (14.3%) of the 21 patients experienced grade 3 late toxicities. The 1- and 2-year local control, progression-free survival, and overall survival rates were 100% and 92.3%, 81.0% and 50.0%, and 90.5% and 80.0%, respectively.
CONCLUSION
C-ion RT using 60 Gy (RBE) in four fractions was safe and achieved promising local tumor control.
背景与目的
评估采用碳离子放疗（C-ion RT）给予 60Gy（相对生物学效应，RBE），4 次分割治疗肝细胞癌（HCC）患者的安全性。
材料与方法
主要结局为 90 天内的急性毒性。次要结局包括迟发性毒性、局部控制率、无进展生存率和总生存率。主要纳入标准为：（1）无大血管侵犯且不毗邻消化道的 3cm 或更大 HCC；（2）Child-Pugh's A/B 级；（3）无肝外转移。
结果
2012 年 10 月至 2016 年 4 月期间共分析了 21 例患者。17 例幸存者的中位随访时间为 24.2（范围：6.3-43.7）个月。未观察到 3 级或以上急性毒性，21 例患者中有 3 例（14.3%）发生 3 级迟发性毒性。1 年和 2 年局部控制率、无进展生存率和总生存率分别为 100%和 92.3%、81.0%和 50.0%、90.5%和 80.0%。
结论
采用 60Gy（RBE），4 次分割的碳离子放疗是安全的，可获得良好的局部肿瘤控制。
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