MRI-guided stereotactic radiation therapy for hepatocellular carcinoma: a feasible and safe innovative treatment approach
MRI-guided stereotactic radiation therapy for hepatocellular carcinoma: a feasible and safe innovative treatment approach
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DOI：
10.1007/s00432-020-03480-8
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发表时间：
2021-01-04
影响因子：
3.6
通讯作者：
Valentini, Vincenzo
中科院分区：
文献类型：
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作者：
Boldrini, Luca;Romano, Angela;Valentini, Vincenzo
目的：早期肝细胞癌（HCC）宜采用局部消融治疗，如射频消融（RFA）或经动脉化疗栓塞（TACE）。在这种情况下，放射治疗（RT）已显示出有希望的结果，但尚未得到彻底的评价。磁共振引导RT（MRgRT）可能代表了立体定向体部放疗（SBRT）治疗肝脏肿瘤的范式转变。方法我们回顾性评价了使用混合低特斯拉MRgRT装置治疗的HCC患者。在5个连续部分中递送> 100戈伊的总生物学有效剂量（BED），尊重适当的危险器官限制。混合MR扫描用于治疗计划，电影MR用于输送门控。对患者进行毒性和治疗反应评估。结果10例患者共12个病灶。所有病变均接受无中断照射。6例患者既往接受过局部治疗。SBRT后的中位随访时间为6.5个月（1-25）。报告了2例急性毒性（G
Purpose Hepatocellular carcinoma (HCC) in early stages benefits from local ablative treatments such as radiofrequency ablation (RFA) or transarterial chemoembolization (TACE). In this context, radiotherapy (RT) has shown promising results but has not been thoroughly evaluated. Magnetic resonance-guided RT (MRgRT) may represent a paradigm shifting improvement in stereotactic body radiotherapy (SBRT) for liver tumors. Methods We retrospectively evaluated HCC patients treated on a hybrid low-tesla MRgRT unit. A total biologically effective dose (BED) > 100 Gy was delivered in 5 consecutive fractions, respecting the appropriate organs-at-risk constraints. Hybrid MR scans were used for treatment planning and cine MR was used for delivery gating. Patients were followed up for toxicity and treatment-response assessment. Results Ten patients were enrolled, with a total of 12 lesions. All the lesions were irradiated with no interruptions. Six patients had already performed previous local therapies. Median follow-up after SBRT was 6.5 months (1-25). Two cases of acute toxicity were reported (G