Bae Bong Kyung, Park Hee Chul, Yu Jeong Il, Yoo Gyu Sang, Sinn Dong Hyun, Choi Moon Seok, Oh Joo Hyun
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Front Oncol. 2022 Jul 22;12:928119. doi: 10.3389/fonc.2022.928119. eCollection 2022.
To present the trends in radiotherapy for the management of hepatocellular carcinoma (HCC) at a single tertiary referral hospital in South Korea.
We retrospectively reviewed prospectively collected registry data of patients newly diagnosed with HCC between January 2005 and December 2017 at the Samsung Medical Center. Trends in radiotherapy, delivery techniques, tumor stage, and age were evaluated.
During the study period, 9,132 patients were newly diagnosed with HCC at our institution. Of these, 2,445 patients (26.8%) received radiotherapy for all lesions, including extrahepatic metastases; 1,865 patients (20.4%) received radiotherapy for intrahepatic lesions alone, and 469 patients (5.1%) received radiotherapy as initial management. Although the proportion of patients receiving radiotherapy increased slightly over the study period (24.2% vs. 26.6%), the proportions of patients receiving radiotherapy for intrahepatic lesions (16.8% vs. 21.9%) and as initial management (0.1% vs. 12.5%) increased dramatically. The majority of patients treated between 2005 and 2008 received three-dimensional conformal radiotherapy (56.3%), whereas the majority of patients treated between 2018 and 2021 received proton beam therapy (43.6%). With the technical developments, the overall survival (OS) of patients who received radiotherapy as initial management increased significantly (5-year OS: from 5.4% to 30.1%), and the OS difference between patients who did and did not receive radiotherapy as initial management significantly decreased (ratio of restricted mean survival time: from 0.383 to 0.544).
This registry-based, retrospective study indicated an increasing trend in the utilization of radiotherapy, adoption of advanced radiotherapy techniques, and OS improvements in patients with HCC.
介绍韩国一家三级转诊医院肝细胞癌（HCC）放射治疗的发展趋势。
我们回顾性分析了2005年1月至2017年12月在三星医疗中心前瞻性收集的新诊断为HCC患者的登记数据。评估了放射治疗、 delivery技术、肿瘤分期和年龄的发展趋势。
在研究期间，我院共有9132例患者新诊断为HCC。其中，2445例患者（26.8%）对所有病灶（包括肝外转移灶）接受了放射治疗；1865例患者（20.4%）仅对肝内病灶接受了放射治疗，469例患者（5.1%）接受了放射治疗作为初始治疗。尽管在研究期间接受放射治疗的患者比例略有增加（24.2%对26.6%），但接受肝内病灶放射治疗的患者比例（16.8%对21.9%）和作为初始治疗的患者比例（0.1%对12.5%）显著增加。2005年至2008年期间接受治疗的大多数患者接受了三维适形放射治疗（56.3%），而2018年至2021年期间接受治疗的大多数患者接受了质子束治疗（43.6%）。随着技术的发展，接受放射治疗作为初始治疗的患者的总生存期（OS）显著提高（5年OS：从5.4%提高到30.1%），接受和未接受放射治疗作为初始治疗的患者之间的OS差异显著减小（受限平均生存时间比：从0.383降低到0.544）。
这项基于登记的回顾性研究表明，HCC患者放射治疗的利用率呈上升趋势，先进放射治疗技术的采用以及OS的改善。
