Radioresponse of hepatocellular carcinoma-treatment of lymph node metastasis.
Radioresponse of hepatocellular carcinoma-treatment of lymph node metastasis.
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DOI：
10.4143/crt.2004.36.1.79
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发表时间：
2004-02-01
影响因子：
4.6
通讯作者：
Seo, Dong Jin
中科院分区：
文献类型：
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作者：
Yoon, Sang Min;Kim, Jong Hoon;Seo, Dong Jin
目得：为了分析肝细胞癌（HCC）的放射反应，使用准确的测量肿瘤大小的肝外淋巴结转移，并获得信息，为今后的治疗原发性intrahepatic lessons.MATERIALS AND METHODS：51肝外淋巴结转移原发性HCC，这可以通过单独的外部放射治疗，包括在本研究中。放射剂量范围为30 - 51戈伊，分次大小为2.0 - 3.0戈伊。通过测量放射治疗完成后0、1和3个月的CT扫描面积来确定反应。存活患者的中位随访时间为10个月。结果：总有效率为76%，重要因素有：放射总剂量、时间剂量分割（TDF）值和生物有效剂量（BED）。45戈伊或更高的剂量显示了93%的客观反应率，如果TDF值高于90，则观察到类似的结果。在大约一半（47%）的患者中，在3个月或更晚时观察到最大反应。在14例存活12个月或更长时间的患者中观察到反应持续时间。在接受小于45戈伊治疗的患者中，观察到4例（66.7%）照射病灶再生，在接受45戈伊或更高剂量治疗的患者中，观察到4例（50%）照射病灶再生。应答者和非应答者之间的生存率存在统计学显著差异（p=0.008）。消化道出血或溃疡8例，其中3例NCI常见毒性标准III级或更高。结论：放射治疗是一种有效的姑息治疗肝癌肝外转移的方式。主要反应需要45戈伊或更高的辐射剂量（或TDF值>或=90）。
PURPOSE: To analyze the radioresponse of hepatocellular carcinomas (HCC), using accurate measurements of the tumor size in extrahepatic lymph node metastasis, and to obtain information for the future treatment of primary intrahepatic lesions.MATERIALS AND METHODS: Fifty-one extrahepatic lymph node metastases from primary HCCs, which could be treated by external radiotherapy alone, were included in this study. The radiation dose ranged from 30 to 51 Gy with fraction sizes of 2.0 approximately 3.0 Gy. Responses were determined by measuring the areas on CT scans 0, 1 and 3 months after the completion of radiotherapy. The median follow-up period of the surviving patients was 10 months.RESULTS: The overall response rate was 76%, and the important factors were; total dose of radiation, time dose fractionation (TDF) value and the biologically effective dose (BED). A dose of 45 Gy or higher showed an objective response rate of 93%, and if the TDF value was higher than 90, a similar result was observed. In about half (47%) of the patients the maximum response was observed at 3 months or later. The response duration was observable in 14 patients surviving 12 months or longer. Regrowth of irradiated lesions were observed in 4 (66.7%) patients among those who received less than 45 Gy, and in 4 (50%) among those who were treated with 45 Gy or more. There was a statistically significant difference in the survivals between the responders and non-responders (p=0.008). Gastrointestinal bleeding or ulceration was observed in 8 patients, including 3 with NCI common toxicity criteria grade III or higher.CONCLUSION: Radiotherapy was an effective palliative modality for extrahepatic metastasis in HCCs. A radiation dose of 45 Gy or higher (or a TDF value >or=90), was required for a major response.