Evaluation of Focal Liver Reaction after Proton Beam Therapy for Hepatocellular Carcinoma Examined Using Gd-EOB-DTPA Enhanced Hepatic Magnetic Resonance Imaging.
Evaluation of Focal Liver Reaction after Proton Beam Therapy for Hepatocellular Carcinoma Examined Using Gd-EOB-DTPA Enhanced Hepatic Magnetic Resonance Imaging.
复制标题
DOI：
10.1371/journal.pone.0167155
复制
发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Gabata T
中科院分区：
文献类型：
--
作者：
Takamatsu S;Yamamoto K;Maeda Y;Kawamura M;Shibata S;Sato Y;Terashima K;Shimizu Y;Tameshige Y;Sasaki M;Asahi S;Kondou T;Kobayashi S;Matsui O;Gabata T
质子束治疗（PBT）对肝细胞癌（HCC）具有良好的局部控制性，且毒性倾向于低于光子放疗。放射治疗中的局灶性肝实质损伤被称为局灶性肝反应（FLR）；本文分析了立体定向消融体放疗和近距离放射治疗中肝内FLR的阈值剂量。为了开发一种更安全的PBT治疗方法，TD和肝脏体积变化在临床上被认为在治疗前预测损伤程度以及随后减少背景性肝损伤方面具有重要意义。我们研究了肝细胞癌PBT后FLR的出现时间、td和体积变化。采用PBT治疗的患者，在PBT治疗后采用钆乙氧基苄基二乙烯三胺五乙酸增强磁共振成像（Gd-EOB-DTPA MRI）随访。58例患者中的68个病变符合分析条件。在治疗结束时以及PBT后1、2、3和6个月进行MRI检查。我们将FLR定义为Gd-EOB-DTPA MRI上清晰描绘的肝胆期低信号区域，并监测FLR区域的td和体积变化以及FLR区域外的残余肝脏。PBT后3个月，所有病变均出现FLR。在以2 Gy当量剂量（α/β = 3 Gy）表示的FLR中，TDs无显著差异（27.0±6.4 CGE[10分数[Fr] vs. 30.5±7.3 CGE[20分数]）。TDs与临床因素无相关性，Child-Pugh A、B评分差异无统计学意义。特别是在最初的3个月，FLR区域的体积减小，残余肝脏体积增加。本研究建立了肝癌的FLR剂量，这可能有助于预测PBT的残肝体积。
Proton beam therapy (PBT) achieves good local control for hepatocellular carcinoma (HCC), and toxicity tends to be lower than for photon radiotherapy. Focal liver parenchymal damage in radiotherapy is described as the focal liver reaction (FLR); the threshold doses (TDs) for FLR in the background liver have been analyzed in stereotactic ablative body radiotherapy and brachytherapy. To develop a safer approach for PBT, both TD and liver volume changes are considered clinically important in predicting the extent of damage before treatment, and subsequently in reducing background liver damage. We investigated appearance time, TDs and volume changes regarding FLR after PBT for HCC. Patients who were treated using PBT and were followed up using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA MRI) after PBT were enrolled. Sixty-eight lesions in 58 patients were eligible for analysis. MRI was acquired at the end of treatment, and at 1, 2, 3 and 6 months after PBT. We defined the FLR as a clearly depicted hypointense area on the hepatobiliary phase of Gd-EOB-DTPA MRI, and we monitored TDs and volume changes in the FLR area and the residual liver outside of the FLR area. FLR was depicted in all lesions at 3 months after PBT. In FLR expressed as the 2-Gy equivalent dose (α/β = 3 Gy), TDs did not differ significantly (27.0±6.4 CGE [10 fractions [Fr] vs. 30.5±7.3 CGE [20 Fr]). There were also no correlations between the TDs and clinical factors, and no significant differences between Child-Pugh A and B scores. The volume of the FLR area decreased and the residual liver volume increased, particularly during the initial 3 months. This study established the FLR dose for liver with HCC, which might be useful in the prediction of remnant liver volume for PBT.
登录
查看更多内容
DOI：
10.1016/j.ijrobp.2008.07.032
发表时间：
2009-04-01
影响因子：
7
作者：
Olsen, C. C.;Welsh, J.;Schefter, T. E.
通讯作者：
Schefter, T. E.
影响因子：
7.3
作者：
Vander Borght, S;Libbrecht, L;Roskams, TA
通讯作者：
Roskams, TA
影响因子：
5.7
作者：
Imada, Hiroshi;Kato, Hirotoshi;Tsujii, Hirohiko
通讯作者：
Tsujii, Hirohiko
影响因子：
4.6
作者：
Haga, Junko;Shimazu, Motohide;Kitagawa, Yuko
通讯作者：
Kitagawa, Yuko
影响因子：
19.7
作者：
Kitao, Azusa;Zen, Yoh;Nakanuma, Yasuni
通讯作者：
Nakanuma, Yasuni