基于反应的肝细胞癌放射治疗的演变。
Evolution of Response-Based Radiotherapy for Hepatocellular Cancer.
机构信息
From the Department of Radiation Oncology, University of Michigan, Ann Arbor, MI.
出版信息
Cancer J. 2023;29(5):266-271. doi: 10.1097/PPO.0000000000000679.
Abstract
Stereotactic body radiation therapy has emerged as a safe and effective treatment modality for properly selected hepatocellular cancer (HCC) patients with normal liver function. However, many HCC patients have reduced baseline liver function due to underlying cirrhosis or prior liver-directed therapies. Therefore, because of the increased risk of hepatotoxicity, the use of stereotactic body radiation therapy for patients with reduced liver function has been approached with caution. Individualized, response-based radiotherapy incorporates models, imaging tools, and biomarkers that determine the dose-response relationship of the liver before, during, and after treatment and has been useful in reducing the likelihood of liver damage without sacrificing tumor control. This review discusses the evolution of response-based radiotherapy for HCC and highlights areas for further investigation.
摘要
立体定向体部放射治疗已成为肝功能正常的肝癌（HCC）患者的一种安全有效的治疗方式。然而，由于基础肝硬化或既往肝定向治疗，许多 HCC 患者的基线肝功能降低。因此，由于肝毒性风险增加，立体定向体部放射治疗在肝功能降低的患者中的应用一直持谨慎态度。个体化、基于反应的放射治疗结合了模型、成像工具和生物标志物，可在治疗前后确定肝脏的剂量反应关系，有助于降低肝损伤的可能性而不影响肿瘤控制。本文讨论了基于反应的 HCC 放射治疗的发展，并强调了进一步研究的领域。
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