Results of three-dimensional conformal radiotherapy and thalidomide for advanced hepatocellular carcinoma
Results of three-dimensional conformal radiotherapy and thalidomide for advanced hepatocellular carcinoma
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DOI：
10.1093/jjco/hyi242
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发表时间：
2006-02-01
影响因子：
2.4
通讯作者：
Lin, GD
中科院分区：
文献类型：
--
作者：
Hsu, WC;Chan, SC;Lin, GD
目的：评价三维适形放疗联合沙利度胺治疗晚期肝癌的疗效。方法：1999 ~ 2003年，121例晚期肝癌患者（平均年龄54.4±12.4岁，范围20 ~ 81岁）接受三维适形放疗和沙利度胺治疗。辐射按1.5 Gy的分量每天两次，每周5天，总剂量为45-75 Gy。平均处理体积为429.52±408.50 cm(3)（范围26.89 ~ 2284.82 cm(3)）。同时给予沙利度胺：109例患者200 mg/天，8例患者300 mg/天，4例患者400 mg/天。分析治疗效果、生存率及影响生存率的因素。结果：61%的患者治疗有效。肝硬化（P = 0.001）和肿瘤大小（P = 0.001）显著影响肿瘤反应。6个月、12个月和24个月的总生存率分别为84.8%、60.0和44.6%。单因素分析显示，肝硬化（P = 0.003）、Karnofsky性能状态（P = 0.007）、肿瘤大小（P < 0.001）、门静脉肿瘤血栓形成（P < 0.001）和甲胎蛋白水平（P = 0.003）显著影响生存。多因素分析显示，只有血栓形成（P = 0.039）和甲胎蛋白水平（P = 0.006）是影响生存的因素。结论：沙利度胺三维适形放疗治疗晚期肝癌疗效显著。
Purpose: To evaluate the effectiveness of three-dimensional conformal radiotherapy and thalidomide in the treatment of advanced hepatocellular carcinoma.Methods: Between 1999 and 2003, 121 patients (mean age, 54.4 +/- 12.4 years; range, 20-81 years) with advanced hepatocellular carcinoma received three-dimensional conformal radiotherapy and thalidomide. Radiation was delivered in 1.5 Gy fractions twice daily for 5 days a week, for a total dose of 45-75 Gy. Mean treatment volume was 429.52 +/- 408.50 cm(3) (range, 26.89-2284.82 cm(3)). Thalidomide was given concomitantly: 200 mg/day in 109 patients, 300 mg/day in 8 patients and 400 mg/day in 4 patients. Treatment responses, survival rates and factors affecting survival were analyzed.Results: Treatment responses were observed in 61% of the patients. Liver cirrhosis (P = 0.001) and tumor size (P = 0.001) significantly affected the tumor responses. Overall survival at 6, 12 and 24 months was 84.8, 60.0 and 44.6%, respectively. On univariate analysis, liver cirrhosis (P = 0.003), Karnofsky performance status (P = 0.007), tumor size (P < 0.001), portal vein tumor thrombosis (P < 0.001) and alpha-fetoprotein level (P = 0.003) were shown to significantly affect survival. On multivariate analysis, only thrombosis (P = 0.039) and alpha-fetoprotein level (P = 0.006) were shown to be factors affecting survival.Conclusions: Three-dimensional conformal radiotherapy with thalidomide seems to be effective in the treatment of advanced hepatocellular carcinoma.