A retrospective study of radiotherapy for spinal bone metastases from hepatocellular carcinoma (HCC)
A retrospective study of radiotherapy for spinal bone metastases from hepatocellular carcinoma (HCC)
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DOI：
10.1093/jjco/hyl128
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发表时间：
2007-01-01
影响因子：
2.4
通讯作者：
Nakagawa, Keiichi
中科院分区：
文献类型：
--
作者：
Nakamura, Naoki;Igaki, Hiroshi;Nakagawa, Keiichi
目的：评价放射治疗对肝细胞癌（HCC）脊柱骨转移的治疗效果。方法：回顾性分析1995年至2004年接受放射治疗的24例门诊HCC脊柱骨转移患者，分析放疗后的门诊率和局部无进展率。 24 名患者中有 8 名 (33%) 在治疗前因放射影像学检查显示脊髓受压于脊柱骨转移。 24 名患者中有 2 名 (8.3%) 在治疗前有一定的脊柱缺陷。 α/β比值为10时的生物等效剂量（BED）范围为39至50.7 Gy（中位44.8 Gy）。结果：中位观察期为5.1个月，范围为0.9至36.0个月。在 24 名患者中，5 名（21%）接受了挽救治疗，而其余 19 名患者中，4 名（21%）在最后一次随访时变得无法行走。 3 个月和 6 个月时的卧床率分别为 85% 和 63%。 3个月和6个月时的局部无进展率分别为53%和47%。结论：BED为39-50.7 Gy（中位44.8 Gy）的放射治疗对于HCC脊柱骨转移患者预防瘫痪的效果不够。需要评估采用高精度辐射技术的剂量递增。
Objective: To evaluate the therapeutic effects of radiotherapy on spinal bone metastases from hepatocellular carcinoma (HCC).Methods: A retrospective review was conducted on 24 ambulatory patients with spinal bone metastases from HCC treated by radiotherapy from 1995 to 2004. Ambulatory rate and local progression-free rate after radiotherapy were analyzed. Eight (33%) of 24 patients had radiographic spinal cord compression from the spinal bone metastases before the treatment. Two (8.3%) of the 24 patients had some spinal deficits before the treatment. Biological equivalent dose (BED) with alpha/beta ratios of 10 ranged from 39 to 50.7 Gy (median 44.8 Gy).Results: The median observation period was 5.1 months ranging from 0.9 to 36.0 months. Among the 24 patients, five(21%) underwent salvage therapies, while of the remaining 19 patients four (21%) became nonambulatory by the last follow-up. The ambulatory rates at 3 months and 6 months were 85 and 63%, respectively. The local progression-free rates at 3 months and 6 months were 53 and 47%, respectively.Conclusions: Radiotherapy with a BED of 39-50.7 Gy (median 44.8 Gy) is not sufficiently effective for the patients with spinal bone metastases from HCC to prevent paralysis. Dose escalation with a highly precise radiation technique will need to be evaluated.