Roquette Isaure, Bogart Emilie, Lacornerie Thomas, Ningarhari Massih, Bibault Jean-Emmanuel, Le Deley Marie-Cecile, Lartigau Eric F, Pasquier David, Mirabel Xavier
Academic Department of Radiation Oncology, Centre Oscar Lambret, 59020 Lille, France.
Department of Biostatistics, Centre Oscar Lambret, 59020 Lille, France.
Cancers (Basel). 2022 Aug 11;14(16):3892. doi: 10.3390/cancers14163892.
This study aimed to describe patient characteristics, treatment efficacy, and safety in patients with hepatocellular carcinoma (HCC) undergoing stereotactic body radiation therapy (SBRT). We retrospectively analyzed data of 318 patients with 375 HCC treated between June 2007 and December 2018. Efficacy (overall survival [OS], relapse-free survival, and local control) and acute and late toxicities were described. The median follow-up period was 70.2 months. Most patients were treated with 45 Gy in three fractions. The median (range) PTV volume was 90.7 (2.6-1067.6) cc. The local control rate at 24 and 60 months was 94% (91-97%) and 94% (91-97%), respectively. Relapse-free survival at 12, 24, and 60 months was 62% (55-67%), 29% (23-36%), and 13% (8-19%), respectively. OS at 12, 24, and 60 months was 72% (95%CI 67-77%), 44% (38-50%), and 11% (7-15%), respectively. Approximately 51% and 38% experienced acute and late toxicity, respectively. Child-Pugh score B-C, high BCLC score, portal thrombosis, high GTV volume, and higher PTV volume reported on total hepatic volume ratio were significantly associated with OS. SBRT is efficient for the management of HCC with a favorable toxicity profile. The outcome is highly related to the natural evolution of the underlying cirrhosis.
本研究旨在描述接受立体定向体部放疗（SBRT）的肝细胞癌（HCC）患者的特征、治疗疗效和安全性。我们回顾性分析了2007年6月至2018年12月期间接受治疗的318例患者375个HCC的数据。描述了疗效（总生存期[OS]、无复发生存期和局部控制）以及急性和晚期毒性。中位随访期为70.2个月。大多数患者接受45 Gy分三次照射。PTV体积的中位数（范围）为90.7（2.6 - 1067.6）cc。24个月和60个月时的局部控制率分别为94%（91 - 97%）和94%（91 - 97%）。12个月、24个月和60个月时的无复发生存率分别为62%（55 - 67%）、29%（23 - 36%）和13%（8 - 19%）。12个月、24个月和60个月时的OS分别为72%（95%CI 67 - 77%）、44%（38 - 50%）和11%（7 - 15%）。分别约有51%和38%的患者经历了急性和晚期毒性。Child-Pugh评分B - C、高BCLC评分、门静脉血栓形成、高GTV体积以及总肝体积比中较高的PTV体积与OS显著相关。SBRT对HCC的治疗有效，毒性特征良好。结果与潜在肝硬化的自然演变高度相关。
