High-biologically effective dose palliative radiotherapy for a tumor thrombus might improve the long-term prognosis of hepatocellular carcinoma: a retrospective study.
High-biologically effective dose palliative radiotherapy for a tumor thrombus might improve the long-term prognosis of hepatocellular carcinoma: a retrospective study.
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DOI：
10.1186/s13014-017-0831-y
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发表时间：
2017-05-31
期刊：
影响因子：
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通讯作者：
Li JL
中科院分区：
文献类型：
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作者：
Kong XQ;Dong YP;Wu JX;He JY;Le YY;Du KX;Peng QQ;Li JL
本研究旨在强调肿瘤血栓的类型，并确定影响有肿瘤血栓的肝细胞癌（HCC）患者长期生存结果的预后因素。肝癌的肿瘤血栓与预后不良有关。在2006年5月至2014年4月期间，80例确诊为HCC并伴有肿瘤血栓的患者被纳入本研究。分析患者的年龄、性别、临床特征、实验室结果、Child-Pugh分型、运动状态（ECOG）、肿瘤血栓类型、放疗方式、生物有效剂量（BED）、主要治疗方法，以确定与总生存率（OS）相关的预后因素。采用SPSS 19.0版本进行统计分析。中位随访时间为24个月（范围6-90）。患者1年、3年、5年OS分别为77.6%、37.6%、18.8%。单因素分析显示，性别、放疗方式、BED、肿瘤血栓类型、Child-Pugh分级、ECOG、总胆红素与OS相关（P < 0.001、P = 0.001、P = 0.016、P = 0.003、P < 0.001、P < 0.001、P = 0.039）。在多因素分析中，OS的预后因素为性别（P < 0.001）、BED （P = 0.044）、Child Pugh分类（P = 0.020）、运动状态（ECOG） （P = 0.004）和肿瘤血栓类型（P = 0.001）。高bed组的中位OS优于低bed组（42个月vs 19个月，P = 0.016）。性别、BED、运动状态（ECOG）、Child-Pugh分类和肿瘤血栓类型似乎会影响OS，并且随着肿瘤血栓类型从I到IV的变化，生存率逐渐下降。高BED姑息放疗可能改善有肿瘤血栓的HCC患者的长期预后。
This study aimed to highlight the type of tumor thrombus and identify the prognostic factors influencing the long-term survival outcomes in patients with hepatocellular carcinoma (HCC) having a tumor thrombus. A tumor thrombus in HCC is associated with poor prognosis. Eighty patients diagnosed with HCC having a tumor thrombus between May 2006 and April 2014 were enrolled in this study. Age, gender, clinical characteristics, laboratory findings, Child-Pugh classification, performance status (ECOG), types of tumor thrombi, radiotherapy method, biologically effective dose (BED), and primary treatment method were analyzed to identify the prognostic factors associated with the overall survival (OS) rates. Statistical analyses were performed using SPSS version 19.0. The median follow-up duration was 24 months (range 6–90). The 1-, 3-, and 5-year OS rates of the patients were 77.6%, 37.6%, and 18.8%, respectively. On univariate analysis, gender, radiotherapy method, BED, types of tumor thrombi, Child-Pugh classification, ECOG, and total bilirubin were associated with OS (P < 0.001, P = 0.001, P = 0.016, P = 0.003, P < 0.001, P < 0.001, P = 0.039, respectively). The prognostic factors for OS in multi-variate analyses were gender (P < 0.001), BED (P = 0.044), Child Pugh classification (P = 0.020), performance status (ECOG) (P = 0.004), and types of tumor thrombi (P = 0.001). The median OS for the high-BED group was better than that for the low-BED groups (42 months vs. 19 months, P = 0.016). Gender, BED, performance status (ECOG), Child-Pugh classification, and types of tumor thrombi seemed to affect OS, and a stepwise decrease in survival was observed with the types of tumor thrombi ranging from I to IV. High-BED palliative radiotherapy might improve the long-term outcomes for patients with HCC having a tumor thrombus.