Lee Sung Uk, Yoon Sang Min, Cheng Jason Chia-Hsien, Kim Tae Hyun, Kim Bo Hyun, Park Jin-Hong, Jung Jinhong, Tsai Chiao-Ling, Chiang Yun, Park Joong-Won
Center for Proton Therapy, National Cancer Center, Goyang, South Korea.
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Front Oncol. 2021 Feb 26;11:646473. doi: 10.3389/fonc.2021.646473. eCollection 2021.
No studies evaluating the clinical outcomes of radiotherapy (RT) for hepatocellular carcinoma (HCC) in the caudate lobe have been available to date. The purpose of this study was to evaluate the effectiveness and safety of RT for HCC in the caudate lobe. Seventy patients with HCC in the caudate lobe treated with RT from a multi-institutional database were included in this study. The median equivalent dose in 2 Gy (EQD2) was 80.0 Gy (range, 31.3-99.3), and freedom from local progression (FFLP), progression-free survival (PFS), and overall survival (OS) rates were evaluated. The median time of follow-up was 47.9 months (range, 3.4-127), and the 5-year FFLP, PFS, and OS rates were 80.6% [95% confidence interval (CI), 70.8-91.8], 13.8% (95% CI, 7.5-25.4), and 51.3% (95% CI, 39.9-66.1), respectively. In the multivariate analysis, the radiation dose was significantly associated with the FFLP rate [hazard ratio (HR), 0.57 per 10 Gy increase, = 0.001], and the status of FFLP was significantly associated with OS (HR, 2.694, = 0.014). The overall rate of ≥grade 3 adverse events was 5.7% (4 of 70), and RT-related mortality was not observed. RT for HCC in the caudate lobe showed promising FFLP and OS rates with safe toxicity profiles. These findings suggest that RT may be a promising treatment option for HCC in the caudate lobe.
迄今为止，尚无评估尾状叶肝细胞癌（HCC）放射治疗（RT）临床结局的研究。本研究的目的是评估RT治疗尾状叶HCC的有效性和安全性。本研究纳入了多机构数据库中70例接受RT治疗的尾状叶HCC患者。2 Gy等效剂量（EQD2）的中位数为80.0 Gy（范围31.3 - 99.3），并评估了局部无进展生存率（FFLP）、无进展生存期（PFS）和总生存期（OS）。中位随访时间为47.9个月（范围3.4 - 127），5年FFLP、PFS和OS率分别为80.6% [95%置信区间（CI），70.8 - 91.8]、13.8%（95% CI，7.5 - 25.4）和51.3%（95% CI，39.9 - 66.1）。在多变量分析中，放射剂量与FFLP率显著相关[风险比（HR），每增加10 Gy为0.57， = 0.001]，FFLP状态与OS显著相关（HR，2.694， = 0.014）。≥3级不良事件的总发生率为5.7%（70例中的4例），未观察到RT相关死亡。尾状叶HCC的RT显示出有前景的FFLP和OS率以及安全的毒性特征。这些发现表明，RT可能是尾状叶HCC的一种有前景的治疗选择。
