Chen S C, Lian S L, Chang W Y
Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.
Cancer Chemother Pharmacol. 1994;33 Suppl:S124-7. doi: 10.1007/BF00686683.
To investigate the effect of external radiotherapy in the control of portal vein invasion (PVI) in hepatocellular carcinoma (HCC), ten patients with cytologically confirmed unresectable HCC were recruited for study. All of the patients were assigned Pugh's classification A, and all had only unilateral PV involvement. The main tumors were treated by transcatheter arterial embolization. The PVI was irradiated with a dose of 3000-5000 cGY using a linear accelerator under localization by real-time ultrasound. All ten patients responded to the external irradiation, with complete disappearance of the PVI occurring in five and partial shrinkage, in the other five. However, the HCC extended to the contralateral PV in two patients, although the irradiated lesion had shrunk. Both patients had shown involvement of the main PV in the initial study. Six patients died after 3, 6, 7, 7, 8, and 10 months, respectively, due to advance of the HCC, rupture, liver failure, and respiratory failure. The others survived for longer than 6 months and remain under follow-up. The branch of PVI at discovery might have an important bearing on the effect of the radiotherapy. No postirradiation hepatitis or other complication was observed.
为研究外照射放疗对肝细胞癌（HCC）门静脉侵犯（PVI）的控制效果，招募了10例经细胞学确诊为不可切除HCC的患者进行研究。所有患者均为普格分级A级，且均仅单侧门静脉受累。主要肿瘤采用经动脉导管栓塞治疗。使用直线加速器在实时超声定位下对PVI进行3000 - 5000 cGY剂量的照射。所有10例患者对外照射均有反应，其中5例PVI完全消失，另5例部分缩小。然而，2例患者尽管照射部位病变缩小，但HCC扩展至对侧门静脉。这2例患者在初始研究中均显示主要门静脉受累。6例患者分别在3、6、7、7、8和10个月后因HCC进展、破裂、肝衰竭和呼吸衰竭死亡。其他患者存活超过6个月，仍在随访中。发现时PVI的分支可能对放疗效果有重要影响。未观察到放疗后肝炎或其他并发症。
