Long-term results of hepatic artery fluorodeoxyuridine and conformal radiation therapy for primary hepatobiliary cancers
Long-term results of hepatic artery fluorodeoxyuridine and conformal radiation therapy for primary hepatobiliary cancers
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DOI：
10.1016/s0360-3016(96)00528-7
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发表时间：
1997-01-15
影响因子：
7
通讯作者：
Ensminger, WD
中科院分区：
文献类型：
--
作者：
Robertson, JM;Lawrence, TS;Ensminger, WD
目的：研究表明，适形放射治疗(RT)联合肝动脉(HA)氟代脱氧尿嘧啶核苷(FdUrd)治疗非弥漫性原发性肝胆恶性肿瘤具有良好的肝功能控制和生存率。随着随访时间的延长，我们特别关注能否实现长期的肝脏控制和无病生存，以及是否观察到放射治疗的晚期肝脏并发症。方法与材料：不能切除的原发性肝胆癌患者同时接受HA FdUrd(0.2 mg/kg/d)和适形放射治疗(1.5~1.65 Gy/次，2次/d)，仅针对肝脏异常，采用三维治疗计划确定靶区和正常肝脏体积，结果：共治疗22例患者(肝细胞癌11例，胆管细胞癌11例)，11例可评价患者中有10例客观反应，2年以上无进展约50%，中位生存期16个月，4年生存率约20%，消化道出血是最常见的远期毒性反应。未观察到晚期肝毒性；结论：适形RT联合HA FdUrd可使不能切除的非弥漫性原发性肝胆恶性肿瘤患者长期免于肝脏进展和生存，无远期肝脏并发症发生。(C)1997年爱思唯尔科学公司。
Purpose: We have previously shown that conformal radiation therapy (RT) combined with hepatic artery (HA) fluorodeoxyuridine (FdUrd) had encouraging hepatic control and survival rates for patients with nondiffuse primary hepatobiliary malignancies. With longer follow-up, we were particularly interested if long-term hepatic control and disease-free survival could be achieved, and if late hepatic complications due to radiation therapy were observed.Methods and Materials: Patients with unresectable primary hepatobiliary cancer were treated with concurrent HA FdUrd (0.2 mg/kg/day) and conformal RT (1.5-1.65 Gy per fraction, twice a day), directed only to the liver abnormalities, Three-dimensional treatment planning was used to define both the target and normal liver volumes, The total dose of radiation (48 or 66 Gy) was determined by the fractional volume of normal liver excluded from the high dose volume, Patients mere followed routinely for response, patterns of failure, long-term toxicity, and survival, The median potential follow-up was 54 months.Results: A total of 22 patients (11 with hepatocellular carcinoma and 11 with cholangiocarcinoma) were treated, There were 10 objective responses in the 11 evaluable patients, The overall freedom from hepatic progression at more than 2 years was about 50%, The median survival was 16 months with an actuarial 4-year survival of about 20%, Gastrointestinal bleeding was the most common long-term toxicity, Late hepatic toxicity was not observed; in fact, hypertrophy of the untreated liver was seen.Conclusions: Combined conformal RT and HA FdUrd can produce long-term freedom from hepatic progression and survival in patients with unresectable, nondiffuse primary hepatobiliary malignancies, There were no longterm liver complications observed. (C) 1997 Elsevier Science Inc.