Hypofractionated stereotactic radiotherapy with and without transarterial chemoembolization for small hepatocellular carcinoma not eligible for other ablation therapies: Preliminary results for efficacy and toxicity
Hypofractionated stereotactic radiotherapy with and without transarterial chemoembolization for small hepatocellular carcinoma not eligible for other ablation therapies: Preliminary results for efficacy and toxicity
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DOI：
10.1111/j.1872-034x.2007.00084.x
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发表时间：
2008-01-01
影响因子：
4.2
通讯作者：
Kubo, Atsushi
中科院分区：
文献类型：
--
作者：
Takeda, Atsuya;Takahashi, Masahiko;Kubo, Atsushi
目的：探讨低分割立体定向放疗在单一机构治疗肝癌的疗效和毒性。方法：16例单发HCC患者，包括2例门静脉肿瘤血栓患者，均行立体定向放疗，伴或不伴经动脉化疗栓塞。立体定向放疗的标准为：其他消融治疗存在技术困难，疾病无法手术或拒绝手术，根据Child-Pugh分级肿瘤分期为A级或B级，远离胃肠道和肾脏的孤立性肿瘤，肿瘤体积< 100 cm(3)。在16名患者中，有14名患者在5-9天内分5-7次给药，总剂量为35-50 Gy。结果：在平均612天（中位611天，范围244-994天）随访结束时，所有患者均存活。16例患者中有8例完全缓解，另外7例判断为稳定，脂醇积累。1例患者在489天后出现局部复发。6例患者肝内复发出现在治疗体积外，随访期间未出现肝外转移。未出现与治疗相关的严重毒性表现。结论：立体定向放疗联合或不联合经动脉化疗栓塞治疗肝癌是一种可行的治疗方法，治疗周期短，局部控制性好。立体定向放疗可能对不能手术或其他消融治疗有困难的患者有临床益处。
Aim: To investigate the efficacy and toxicity of hypofractionated stereotactic radiotherapy for the treatment of patients presenting with hepatocellular carcinoma (HCC) in a single institutional setting.Methods: Sixteen patients who presented with solitary HCC, including two patients with a tumor thrombus of the portal veins, were treated with stereotactic radiotherapy with or without transarterial chemoembolization. The criteria for stereotactic radiotherapy were existence of technical difficulties for other ablation therapies, inoperable disease or refusal to undergo surgery, tumor staged as Grade A or B according to the Child-Pugh classification, and solitary tumor distant from the gastrointestinal tract and kidney with a tumor volume < 100 cm(3). In 14 of 16 patients, a total dose of 35-50 Gy was delivered in 5-7 fractions over 5-9 days.Results: At the end of a mean follow-up of 612 days (median 611 days; range 244-994 days), all patients were alive. Eight of 16 patients had complete responses and seven others were judged as stable with lipiodol accumulation. In one patient, local recurrence developed after 489 days. Intrahepatic recurrences developed outside the treated volume in six patients and no extrahepatic metastases developed during follow-up. No serious treatment-related toxic manifestations developed.Conclusions: Stereotactic radiotherapy for HCC with or without transarterial chemoembolization is feasible therapy and provides good local control with a short treatment period. Stereotactic radiotherapy may be of clinical benefit in patients who are inoperable or for whom there are difficulties in other ablation therapies.