Bae Bong Kyung, Yu Jeong Il, Park Hee Chul, Goh Myung Ji, Paik Yong-Han
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiation Oncology, Kyungpook National University Chilgok Hospital, Daegu, Korea.
Radiat Oncol J. 2023 Jun;41(2):98-107. doi: 10.3857/roj.2023.00353. Epub 2023 Jun 22.
To report the trends of radiotherapy in the management of elderly patients with hepatocellular carcinoma (HCC).
We retrospectively reviewed patients who entered HCC registry of Samsung Medical Center between 2005 and 2017. Patients who were 75 years or older at the time of registration were defined as elderly. They were categorized into three groups based on the year of registration. Radiotherapy characteristics were compared between the groups to observe differences by age groups and period of registration.
Out of 9,132 HCC registry patients, elderly comprised 6.2% (566 patients) of the registry, and the proportion increased throughout the study period (from 3.1% to 11.4%). Radiotherapy was administered to 107 patients (18.9%) in elderly group. Radiotherapy utilization in the early treatment process (within 1 year after registration) has rapidly increased from 6.1% to 15.3%. All treatments before 2008 were delivered with two-dimensional or three-dimensional conformal radiotherapy, while more than two-thirds of treatments after 2017 were delivered with advanced techniques such as intensity-modulated radiotherapy, stereotactic body radiotherapy, or proton beam therapy. Overall survival (OS) of elderly was significantly worse than younger patients. However, for patients who received radiotherapy during the initial management (within one month after registration), there was no statistically significant difference in OS between age groups.
The proportion of elderly HCC is increasing. Radiotherapy utilization and adoption of advanced radiotherapy technique showed a consistently increasing trend for the group of patients, indicating that the role of radiotherapy in the management of elderly HCC is expanding.
报告老年肝细胞癌（HCC）患者放疗管理的趋势。
我们回顾性分析了2005年至2017年进入三星医疗中心HCC登记系统的患者。登记时年龄在75岁及以上的患者被定义为老年人。根据登记年份将他们分为三组。比较各组之间的放疗特征，以观察不同年龄组和登记时期的差异。
在9132例HCC登记患者中，老年人占登记系统的6.2%（566例患者），且这一比例在整个研究期间有所增加（从3.1%增至11.4%）。老年组中有107例患者（18.9%）接受了放疗。早期治疗过程（登记后1年内）中的放疗使用率从6.1%迅速增至15.3%。2008年以前的所有治疗均采用二维或三维适形放疗，而2017年以后超过三分之二的治疗采用了调强放疗、立体定向体部放疗或质子束治疗等先进技术。老年人的总生存期（OS）明显低于年轻患者。然而，对于在初始治疗期间（登记后1个月内）接受放疗的患者，各年龄组之间的OS无统计学显著差异。
老年HCC患者的比例在增加。放疗使用率和先进放疗技术的采用在该组患者中呈持续上升趋势，表明放疗在老年HCC管理中的作用正在扩大。
