Comparison of Stereotactic Body Radiation Therapy Combined With or Without Transcatheter Arterial Chemoembolization for Patients With Small Hepatocellular Carcinoma Ineligible for Resection or Ablation Therapies.
Comparison of Stereotactic Body Radiation Therapy Combined With or Without Transcatheter Arterial Chemoembolization for Patients With Small Hepatocellular Carcinoma Ineligible for Resection or Ablation Therapies.
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DOI：
10.1177/1533033818783450
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发表时间：
2018-01-01
影响因子：
2.8
通讯作者：
Nagata Y
中科院分区：
文献类型：
--
作者：
Kimura T;Aikata H;Doi Y;Imano N;Takeuchi Y;Takahashi I;Nishibuchi I;Katsuta T;Kenjo M;Murakami Y;Awai K;Chayama K;Nagata Y
比较立体定向体放射治疗合并或不经导管动脉化疗栓塞治疗不适合切除或消融治疗的小肝癌患者的疗效和安全性。对185例肝癌（≤3个结节，Child-Turcotte-Pugh A或B级，无血管或肝外转移）患者150例进行立体定向全身放射治疗。原则上在立体定向放射治疗前联合行经导管动脉化疗栓塞（联合组），但部分患者单独行立体定向放射治疗。立体定向放射治疗的规定剂量为48 Gy，在等中心分4次，40 Gy，分4次或5次，剂量覆盖计划靶体积的95%。回顾性比较两组患者的总生存期、无进展生存期、局部无进展生存期和并发症发生率。在动态计算机断层扫描随访中，局部进展被定义为放射肿瘤生长。肿瘤反应根据实体瘤的修正反应评价标准进行评估。根据不良事件通用术语标准4.0版评估治疗相关毒性。分别有28名和122名患者参加了立体定向放射治疗单独组和联合组。中位随访期分别为16个月和29个月。立体定向放疗组和联合放疗组的2年总生存期、无进展生存期和局部无进展生存期分别为78.6%和80.3% （P = 0.6583）、49.0%和42.9% （P = 0.188）、71.4%和80.8% （P = 0.9661）。立体定向放疗组≥3级毒副反应发生率为17.9%，联合放疗组为18.9% （P = .903）。对于不适合切除或消融治疗的小肝癌患者，单纯立体定向体放射治疗可能是一个很好的治疗选择。
To compare the efficacy and safety of stereotactic body radiation therapy with or without transcatheter arterial chemoembolization for patients with small hepatocellular carcinoma who were ineligible for resection or ablation therapies. A total of 150 patients with 185 hepatocellular carcinoma (≤3 nodules, Child-Turcotte-Pugh class A or B, and no vascular or extrahepatic metastases) were treated with stereotactic body radiation therapy. In principle, transcatheter arterial chemoembolization was combined before stereotactic body radiation therapy (combination group), but some patients were treated with stereotactic body radiation therapy alone. The prescribed dose of stereotactic body radiation therapy was 48 Gy in 4 fractions at the isocenter and 40 Gy in 4 or 5 fractions at the dose covering 95% of the planning target volume. The overall survival, progression-free survival, local progression free survival, and complication rates were retrospectively compared between the groups. Local progression was defined as irradiated tumor growth in dynamic computed tomography follow-up. Tumor responses were assessed according to the Modified Response Evaluation Criteria in Solid Tumors. Treatment-related toxicities were evaluated according to the Common Terminology Criteria for Adverse Events version 4.0. Twenty-eight and 122 patients were enrolled in the stereotactic body radiation therapy alone and combination groups, respectively. The median follow-up periods were 16 and 29 months, respectively. The 2-year overall, progression-free, and local progression-free survival times in stereotactic body radiation therapy alone and combination groups were 78.6% and 80.3% (P = .6583), 49.0% and 42.9% (P = .188), and 71.4% and 80.8% (P = .9661), respectively. The incidence of ≥grade 3 toxicities was 17.9% in stereotactic body radiation therapy alone group and 18.9% in combination group (P = .903). Stereotactic body radiation therapy alone may be a good treatment option for patients with small hepatocellular carcinoma who were ineligible for resection or ablation therapies.
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影响因子：
3.8
作者：
Kawahara，Daisuke;Ozawa，Shuichi;Nagata，Yasushi
通讯作者：
Nagata，Yasushi
影响因子：
28.4
作者：
Huo, Ya Ruth;Eslick, Guy D.
通讯作者：
Eslick, Guy D.
DOI：
10.1016/j.jvir.2006.12.004
发表时间：
2007-03-01
影响因子：
2.9
作者：
Miyayama, Shiro;Matsui, Osamu;Mitsui, Takeshi
通讯作者：
Mitsui, Takeshi
影响因子：
6.2
作者：
Kang, Jin-Kyu;Kim, Mi-Sook;Kim, Young Han
通讯作者：
Kim, Young Han
影响因子：
6.2
作者：
Takeda, Atsuya;Sanuki, Naoko;Kunieda, Etsuo
通讯作者：
Kunieda, Etsuo