Uchinami Yusuke, Katoh Norio, Abo Daisuke, Taguchi Hiroshi, Yasuda Koichi, Nishioka Kentaro, Soyama Takeshi, Morita Ryo, Miyamoto Naoki, Suzuki Ryusuke, Sho Takuya, Nakai Masato, Ogawa Koji, Kakisaka Tatsuhiko, Orimo Tatsuya, Kamiyama Toshiya, Shimizu Shinichi, Aoyama Hidefumi
Department of Radiation Oncology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
Hepatol Res. 2021 Aug;51(8):870-879. doi: 10.1111/hepr.13649. Epub 2021 May 11.
To report the outcomes of stereotactic body radiotherapy using a real-time tumor-tracking radiotherapy system for hepatocellular carcinoma patients.
From January 2005 to July 2018, 63 patients with 74 lesions with a maximum diameter ≤52 mm were treated by stereotactic body radiotherapy using a real-time tumor-tracking radiotherapy system. No patient with a Child-Pugh Score ≥9 was included, and 85.6% had a score of 5 or 6. Using the biological effective dose (BED) with an α/β ratio of 10 (BED ), the median dose in BED at the reference point was 76.8 Gy (range 60-122.5 Gy). Overall survival (OS) and local control rates were assessed using the Kaplan-Meier method.
With a median follow-up period of 24.6 months (range 0.9-118.4 months), the 1-year and 2-year OS rates were 86.8% (95% confidence interval [95% CI] 75.8-93.3) and 71.1% (57.8-81.6), respectively. The 2-year OS was 89.6% in patients with the baseline modified albumin-bilirubin (mALBI) grade =1, and 61.7% in patients with grade ≥2a. In the multivariate analysis, the mALBI grade (=1 vs. ≥2a) was a significant factor for OS (p = 0.028, 95% CI 1.11-6.18). The 1-year and 2-year local control rates were 100% (100-100%) and 92.0% (77.5-97.5%). The local control rates were significantly higher in the BED ≥100 Gy group than in the BED <100 Gy group (2-year 100% vs. 86.5%, p = 0.049) at the reference point.
This retrospective study of stereotactic body radiotherapy using real-time tumor-tracking radiotherapy for hepatocellular carcinoma showed favorable outcomes with lower incidence of toxicities, especially in patients treated with BED ≥100 Gy to the reference point.
报告使用实时肿瘤追踪放疗系统对肝细胞癌患者进行立体定向体部放疗的结果。
2005年1月至2018年7月，63例患者的74个最大直径≤52mm的病灶接受了使用实时肿瘤追踪放疗系统的立体定向体部放疗。未纳入Child-Pugh评分≥9分的患者，85.6%的患者评分为5或6分。使用α/β比值为10的生物等效剂量（BED），参考点处BED的中位剂量为76.8Gy（范围60 - 122.5Gy）。采用Kaplan-Meier法评估总生存期（OS）和局部控制率。
中位随访期为24.6个月（范围0.9 - 118.4个月），1年和2年OS率分别为86.8%（95%置信区间[95%CI]75.8 - 93.3）和71.1%（57.8 - 81.6）。基线改良白蛋白-胆红素（mALBI）1级患者的2年OS率为89.6%，≥2a级患者为61.7%。多因素分析中，mALBI分级（=1 vs.≥2a）是OS的显著因素（p = 0.028，95%CI 1.11 - 6.18）。1年和2年局部控制率分别为100%（100 - 100%）和92.0%（77.5 - 97.5%）。参考点处BED≥100Gy组的局部控制率显著高于BED<100Gy组（2年时分别为100%和86.5%，p = 0.049）。
这项对肝细胞癌使用实时肿瘤追踪放疗进行立体定向体部放疗的回顾性研究显示出良好的结果，毒性发生率较低，尤其是参考点处BED≥100Gy治疗的患者。
