碳离子放疗作为Child-Pugh B级肝硬化肝细胞癌的局部治疗选择
Carbon-Ion Radiotherapy as a Local Treatment Option for Hepatocellular Carcinoma With Child-Pugh Class B Cirrhosis.
作者信息
Shiba Shintaro, Tsuchida Keisuke, Mizoguchi Nobutaka, Kawashiro Shohei, Shima Satoshi, Kano Kio, Okada Kohei, Koge Hiroaki, Okuda Tatsuya, Kuzuu Riho, Yoshida Daisaku, Katoh Hiroyuki
机构信息
Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
Department of Radiation Oncology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
出版信息
Adv Radiat Oncol. 2025 May 17;10(8):101812. doi: 10.1016/j.adro.2025.101812. eCollection 2025 Aug.
PURPOSE
The local treatment strategy for fragile patients with hepatocellular carcinoma (HCC) with Child-Pugh class B (CP-B) remains unclear. In this study, we evaluated the safety and efficacy of carbon-ion radiation therapy (CIRT) for HCC with CP-B.
METHODS AND MATERIALS
Fifteen consecutive patients with HCC with CP-B who received CIRT between March 2017 and June 2023 were analyzed. Survival and local control probabilities were calculated using the Kaplan-Meier method. Treatment-related liver toxicities were defined as a ≥2-point increase in CP score within 6 months of CIRT.
RESULTS
The median follow-up duration after CIRT was 18.7 months. The median age of patients at the time of registration for CIRT was 71 years. The median tumor size was 51 mm. Eleven patients had a CP score of 7, 3 had a score of 8, and 1 had a score of 9. The number of patients with treatment-naïve and recurrent HCC was 6 and 9, respectively. The 1- and 2-year overall survival rates were 67% and 50%, respectively. The 1- and 2-year local control rates were both 94%. The 1- and 2-year progression-free survival rates were 67% and 11%, respectively. Four patients (27%) experienced treatment-related liver toxicities. No patient developed grade 3 or higher toxicities during the acute and late phases.
CONCLUSIONS
Overall, this study showed the safety and efficacy of CIRT for HCC with CP-B. CIRT is a local treatment option for HCC with CP-B.
目的
对于Child-Pugh B级（CP-B）的肝细胞癌（HCC）脆弱患者，局部治疗策略仍不明确。在本研究中，我们评估了碳离子放疗（CIRT）治疗CP-B级HCC的安全性和有效性。
方法和材料
分析了2017年3月至2023年6月期间连续接受CIRT治疗的15例CP-B级HCC患者。使用Kaplan-Meier方法计算生存率和局部控制概率。治疗相关的肝脏毒性定义为CIRT后6个月内CP评分增加≥2分。
结果
CIRT后的中位随访时间为18.7个月。接受CIRT登记时患者的中位年龄为71岁。中位肿瘤大小为51mm。11例患者CP评分为7分，3例评分为8分，1例评分为9分。初治和复发性HCC患者的数量分别为6例和9例。1年和2年总生存率分别为67%和50%。1年和2年局部控制率均为94%。1年和2年无进展生存率分别为67%和11%。4例患者（27%）出现治疗相关的肝脏毒性。在急性期和晚期，没有患者出现3级或更高等级的毒性。
结论
总体而言，本研究显示了CIRT治疗CP-B级HCC的安全性和有效性。CIRT是CP-B级HCC的一种局部治疗选择。
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