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Research progress on target delineation for radiotherapy in hepatocellular carcinoma with
Lin Haimin, Liu Chengxin, Han Dali, Yu Jinming
1Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Ji′nan 250117,China; 2School of Medicine and Life Sciences, University of Ji′nan-Shandong Academy of Medical Science, Ji′nan 250200, China
Abstract Modern medical imaging techniques, such as computed tomorgraphy (CT), magnetic resonance imaging (MRI) and position emission tomorgraphy/computed tomorgraphy (PET-CT) can accurately delineate the gross target volume (GTV) of hepatocellular carcinoma (HCC). Comparison of postoperative pathological subclinical lesions, imaging and clinical parameters contributes to the precise delineation of clinical target volume (CTV). Moreover, radiotherapy-assisted techniques, such as four-dimensional computed tomography (4DCT), compression of abdomen, active breathing control and respiratory gating, can minimize the internal target volume (ITV). In addition, immobilization with vacuum cushion and body membrane can reduce the set-up error,minimize the planning target volume (PTV) and avoid or decrease the irradiation error or missing irradiation. All these approach can minimize the target volume, elevate the dose and reduce the complications during radiotherapy for HCC. In this article, the research progress on the target delineation for external beam radiotherapy in HCC patients was reviewed.
Corresponding Authors:
Han Dali, Email:dalihan_sdch@163.com
Cite this article:
Lin Haimin,Liu Chengxin,Han Dali et al. Research progress on target delineation for radiotherapy in hepatocellular carcinoma with[J]. Chinese Journal of Radiation Oncology, 2019, 28(7): 551-554.
Lin Haimin,Liu Chengxin,Han Dali et al. Research progress on target delineation for radiotherapy in hepatocellular carcinoma with[J]. Chinese Journal of Radiation Oncology, 2019, 28(7): 551-554.
[1]Chen W,Zheng R,Baade PD,et al. Cancer statistics in china,2015[J]. CA Cancer J Clin,2016,66(2):115-132. DOI:10.3322/caac.21338. [2]Xu G,Zhu L,Wang Y,et al. Stattic enhances radiosensitivity and reduces radio-induced migration and invasion in hcc cell lines through an apoptosis pathway[J]. Biomed Res Int,2017,2017:1832494. DOI:10.1155/2017/1832494. [3]Choi C,Koom WS,Kim TH,et al. A prospective phase 2 multicenter study for the efficacy of radiation therapy following incomplete transarterial chemoembolization in unresectable hepatocellular carcinoma[J]. Int J Radiat Oncol Biol Phys,2014,90(5):1051-1060. DOI:10.1016/j.ijrobp.2014.08.011. [4]Que J,Kuo HT,Lin LC,et al. Clinical outcomes and prognostic factors of cyberknife stereotactic body radiation therapy for unresectable hepatocellular carcinoma[J]. BMC Cancer,2016,16:451. DOI:10.1186/s12885-016-2512-x. [5]Gregoire V,Mackie TR. State of the art on dose prescription,reporting and recording in intensity-modulated radiation therapy (icru report no.83)[J]. Cancer Radiother,2011,15(6-7):555-559. DOI:10.1016/j.canrad.2011.04.003. [6]谢春芳,刘孟忠,习勉. 肝癌影像学与病理学靶区关系的研究[J]. 中国肿瘤临床,2010,37(21):1245-1248. DOI:10.3969/j.issn.1000-8179.2010.21.011. Xie CF,Liu MZ,Xi M. A comparative study on radiology and pathology target voleme in hepatocellular carcinoma[J]. Chin J Clin Oncol,2010,37(21):1245-1248. DOI:10.3969/j.issn.1000-8179.2010.21.011. [7]Chen HY,Hou YL,Ma XM,et al. Ct and mri in target delineation in primary hepatocellular carcinoma[J]. Cancer Radiother,2013,17(8):750-754. DOI:10.1016/j.canrad.2013.05.016. [8]杜晓杰,王璐,魏常宏. 磁共振成像在原发性肝癌诊断治疗中的应用进展[J]. 中国综合临床,2012,28(13):131-133. DOI:10.3760/cma.j. Issil1008-6315.2012.13.071. Du XJ,Wang L,Wei CH. Application of MRI in the diagnosis and treatment of primary liver cancer[J]. Clin Med China,2012,28(13):131-133. DOI:10.3760/cma.j.issil1008-6315.2012.13.071. [9]Klasen J,Heusner TA,Riegger C,et al. Modern CT and PET-CT imaging of the liver[J]. Der Radiol,2011,51(8):671-679. DOI:10.1007/s00117-010-2125-3. [10]Ahn SJ,Park MS,Kim KA,et al.18F-FDG PET metabolic parameters and mri perfusion and diffusion parameters in hepatocellular carcinoma:A preliminary study[J]. PloS One,2013,8(8):e71571. DOI:10.1371/journal.pone.0071571. [11]Ho CL,Yu SC,Yeung DW.11C-acetate pet imaging in hepatocellular carcinoma and other liver masses[J]. J Nucl Med,2003,44(2):213-221. [12]Talbot JN,Gutman F,Fartoux L,et al. PET-CT in patients with hepatocellular carcinoma using 18F fluorocholine:preliminary comparison with 18F-FDG PET-CT[J]. Eur J Nucl Med Mol Imaging 2006,33:1285-1289. DOI:10.1007/s00259-006-0164-9. [13]Park W,Lim DH,Paik SW,et al. Local radiotherapy for patients with unresectable hepatocellular carcinoma[J]. Int J Radiat Oncol Biol Phys,2005,61(4):1143-1150. DOI:10.1016/j.ijrobp.2004.08.028. [14]Mornex F,Girard N,Beziat C,et al. Feasibility and efficacy of high-dose three-dimensional-conformal radiotherapy in cirrhotic patients with small-size hepatocellular carcinoma non-eligible for curative therapies— mature results of the french phase Ⅱ RTF-1 trial[J]. Int J Radiat Oncol Biol Phys,2006,66(4):1152-1158. DOI:10.1016/j.ijrobp.2006.06.015. [15]Kim TH,Kim DY,Park JW,et al. Three-dimensional conformal radiotherapy of unresectable hepatocellular carcinoma patients for whom transcatheter arterial chemoembolization was ineffective or unsuitable[J]. Am J Clin Oncol,2006,29(6):568-575. DOI:10.1097/01.coc.0000239147.60196.11. [16]Wang MH,Ji Y,Zeng ZC,et al. Impact factors for microinvasion in patients with hepatocellular carcinoma:Possible application to the definition of clinical tumor volume[J]. Int J Radiat Oncol Biol Phys, 2010,76(2):467-476. DOI:10.1016/j.ijrobp.2009.01.057. [17]Wang W,Feng X,Zhang T,et al. Prospective evaluation of microscopic extension using whole-mount preparation in patients with hepatocellular carcinoma:definition of clinical target volume for radiotherapy[J]. Radiat Oncol,2010,5:73. DOI:10.1186/1748-717X-5-73. [18]Chen MY,Wang YC,Wu TH,et al. Efficacy of external beam radiation-based treatment plus locoregional therapy for hepatocellular carcinoma associated with portal vein tumor thrombosis[J]. Biomed Res Int,2016,2016:6017406. DOI:10.1155/2016/6017406 [19]Yamada K,Soejima T,Sugimoto K,et al. Pilot study of local radiotherapy for portal vein tumor thrombus in patients with unresectable hepatocellular carcinoma[J]. Japan J Clin Oncol,2001,31(4):147-152. [20]Shirai S,Sato M,Suwa K,et al. Feasibility and efficacy of single photon emission computed tomography-based three-dimensional conformal radiotherapy for hepatocellular carcinoma 8 cm or more with portal vein tumor thrombus in combination with transcatheter arterial chemoembolization[J]. Int J Radiat Oncol Biol Phys,2010,76(4):1037-1044. DOI:10.1016/j.ijrobp.2009.03.023. [21]Wee CW,Kim K,Chie EK,et al. Prognostic stratification and nomogram for survival prediction in hepatocellular carcinoma patients treated with radiotherapy for lymph node metastasis[J]. Br J Radiol,2016,89(1065):20160383. DOI:10.1259/bjr.20160383. [22]Lock MI,Klein J,Chung HT,et al. Strategies to tackle the challenges of external beam radiotherapy for liver tumors[J]. World J Hepatol,2017,9(14):645-656. DOI:10.4254/wjh.v9.i14.645. [23]Akino Y,Oh RJ,Masai N,et al. Evaluation of potential internal target volume of liver tumors using cine-mri[J]. Med Phys,2014,41(11):111704. DOI:10.1118/1.4896821. [24]刘强,李楠,孙彬.4D-CT重建技术在肝癌精确放疗定位的应用效果[J]. 胃肠病学和肝病学杂志,2016,25(8):885-888. DOI:10.3969/j.issn.1006-5709.2016.08.012. Liu Q,Li N,Sun B,et al. Effect of 4D-CT reconstruction technique in accurate radiotherapy for hepatocellular carcinoma[J]. Chin J Gastroenter Hepatol,2016,25(8):885-888. DOI:10.3969/j.issn.10065709.2016.08.012. [25]习勉,刘孟忠,邓小武,等. 应用4D-CT技术确定肝癌内靶体积及相关剂量学研究[J]. 癌症,2007,26(1):1-8. Xi M,Liu MZ,Deng XW,et al. Internal target volume definition using four-dimensional CT and dosimetric evaluation for hepatocellular carcinoma[J]. Chin J Cancer,2007,26(1):1-8. [26]邢军,李建斌,李凤祥,等. 四维CT中三种方法勾画原发性肝癌内大体靶体积的比较研究[J]. 中华放射肿瘤学杂志,2012,34(2):122-128. DOI:10.3760/cma.j.issn.0253-3766.2012.02.009. Xing J,Li JB,Li FX,et al. Comparison of three methods to delineate internal gross target volume of the primary hepatocarcinoma based on four-dimensional CT simulation images[J]. Chin J Radiat Oncol,2012, 34(2):122-128. DOI:10.3760/cma.j.issn.0253-3766.2012.02.009. [27]刘进,孙菁. 四维CT确定肝癌放疗内靶区的临床应用[J]. 中国临床医学,2016,23(3):319-323. Liu J,Sun J. Use of four-dimensional computed tomography scans to determine internal target volume for hepatic malignancies[J]. Chin J Clin Med,2016,23(3):319-323. [28]Hu Y,Zhou YK,Chen YX,et al.4D-CT scans reveal reduced magnitude of respiratory liver motion achieved by different abdominal compression plate positions in patients with intrahepatic tumors undergoing helical tomotherapy[J]. Med Phys,2016,43(7):4335. DOI:10.1118/1.4953190. [29]Zhong R,Wang J,Jiang X,et al. Hypofraction radiotherapy of liver tumor using cone beam computed tomography guidance combined with active breath control by long breath-holding[J]. Radiother Oncol,2012,104(3):379-385. DOI:10.1016/j.radonc.2011.11.007. [30]Gong GZ,Yin Y,Xing LG,et al. Rapidarc combined with the active breathing coordinator provides an effective and accurate approach for the radiotherapy of hepatocellular carcinoma[J]. Strahlenther Onkol,2012, 188(3):262-268. DOI:10.1007/s00066-011-0044-5. [31]巩贯忠,尹勇,陈进琥,等. 基于四维CT和ABC辅助下三维CT确定肝癌内靶区对照研究[J]. 中华放射肿瘤学杂志,2011, 20(6):517-520. Gong GZ,Yin Y,Chen JH,et al. The individual internal gross target volume for hepatocellular carcinoma:four-dimensional CT vs. three-dimensional CT associated with active breathing control[J]. Chin J Radiat Oncol,2011,20(6):517-520. [32]Xi M,Zhang L,Liu MZ,et al. Dosimetric analysis of respiratory-gated radiotherapy for hepatocellular carcinoma[J]. Med Dosim,2011,36(2):213-218. DOI:10.1016/ j.meddos.2010.03.006. [33]Fernandes AT,Apisarnthanarax S,Yin L,et al. Comparative assessment of liver tumor motion using cine-magnetic resonance imaging versus 4-dimensional computed tomography[J]. Int J Radiat Oncol Biol Phys,2015,91(5):1034-1040. DOI:10.1016/j.ijrobp.2014.12.048. [34]Gkika E,Schultheiss M,Bettinger D,et al. Excellent local control and tolerance profile after stereotactic body radiotherapy of advanced hepatocellular carcinoma[J]. Radiat Oncol,2017,12(1):116. DOI:10.1186/ s13014-017-0851-7. [35]Park JH,Yoon SM,Lim YS,et al. Two-week schedule of hypofractionated radiotherapy as a local salvage treatment for small hepatocellular carcinoma[J]. J Gastroenterol Hepatol,2013,28(10):1638-1642. DOI:10.1111/jgh.12249. [36]Hasan S,Thai N,Uemura T,et al. Hepatocellular carcinoma with child pugh-a cirrhosis treated with stereotactic body radiotherapy[J]. World J Gastroint Surg,2017,9(12):256-263. DOI:10.4240/wjgs.v9.i12.256.
2019, Vol. 28 
