无法切除局限于肝内的肝细胞肝癌HT临床疗效观察

doi:10.3760/cma.j.issn.1004-4221.2016.06.010

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Abstract Objective To evaluate the safety of helical tomotherapy (HT) for hepatocellular carcinoma confined to the liver, and to investigate the efficacy of HT by comparison with three-dimensional conformal radiotherapy (3DCRT). Methods In June 2011, hypofractionated HT was performed in 35 patients with unresectable hepatocellular carcinoma confined to the liver who had no distant metastasis or tumor thrombosis. The dose in each fraction increased from 2.4 Gy to 5.0 Gy with a median dose of 3.2 Gy. The median dose for the total treatment was 50.0 Gy. Within the same period, 45 patients received conventionally fractionated 3DCRT with a median dose of 54.0 Gy. The adverse reactions, clinical outcomes, and survival time were compared between the two groups. The survival rate was calculated with Kaplan-Meier method,and log-rank test was used to estimate statistical significance of survival differences. Multivariate analysis of survival was carried out with Cox’s regression model. Results There were no significant differences in adverse reactions between the two groups. TheObjective response rate was significantly higher in the HT group than in the 3DCRT group (60% vs. 33%, P=0.024). There was no significant difference in the disease control rate between the two groups (94% vs. 89%, P=0.459). The HT group showed significantly higher 1-, 2-, and 3-year overall survival rates than the 3DCRT group (97% vs. 80%, P=0.025;81% vs. 55%, P=0.008;67% vs. 50%, P=0.048). The multivariate analysis indicated that tumor smaller than 8 cm, transarterial chemoembolization before radiotherapy, and HT were associated with improved survival (P=0.005;P=0.000;P=0.002). Conclusions HT shows an advantage in precise treatment of hepatocellular carcinoma confined to the liver. With acceptable toxicity, hypofractionated HT shortens the treatment duration and improves the survival in patients.

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	Articles by authors
	Jiang Tao
	Zeng Zhaochong
	Yang Ping
	Hu Yong

Key words： Liver neoplasms/radiotherapy Radiotherapy, helicaltomo Radiotherapy, three-dimensional conformal Prognosis

Received: 26 March 2015

Cite this article:

Jiang Tao,Zeng Zhaochong,Yang Ping et al. Hypofraction radiotherapy by helical tomotherapy for unresectable but confined intrahepatic hepatocellular carcinoma is efficient and safe in comparison with conventional 3-dimension conformal radiotherapy　[J]. Chinese Journal of Radiation Oncology, 2016, 25(6): 588-592.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.06.010 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I6/588

[1] Jemal A,Bray F,Center MM,et al. Global cancer statistics[J].CA Cancer J Clin,2011,61(2):69-90.DOI:10.3322/caac.20107.
[2] Xiong ZP,Huang F,Lu MH.Association between insulin-like growth factor-2 expression an prognosis after transcatheter arterial chemoembolization and octreotide in patients with hepatocellular carcinoma[J].Asian Pac J Cancer Prev,2012,13(7):3191-3194.DOI:10.7314/APJCP.2012.13.7.3191.
[3] Tabrizian P,Roayaie S,Schwartz ME.Current management of hepatocellular carcinoma[J].World J Gastroenterol,2014,20(30):10223-10237.DOI:10.3748/wjg.v20.i30.10223.
[4] Bruix J,Sherman M,American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma:an update[J].Hepatology,2011,53(3):1020-1022.DOI:10.1002/ hep.24199.
[5] Bruix J,Sherman M.Management of hepatocellular carcinoma[J].Hepatology,2005,42(5):1208-1236.DOI:10.1002/hep.20933.
[6] Keall PJ,Joshi S,Vedam SS,et al. Four-dimensional radiotherapy planning for DMLC-based respiratory motion tracking[J].Med Phys,2005,32(4):942-951.DOI:10.1118/ 1.1879152.
[7] Xi M,Liu MZ,Deng XW,et al. Defining internal target volume (ITV) for hepatocellular carcinoma using four-dimensional CT[J].Radiother Oncol,2007,84(3):272-278.DOI:10.1016/j.radonc.2007.07.021.
[8] U. S.Department of Health and Human Services. Common terminology criteria for adverse events (CTCAE) Version 4.0[EB/OL].2010-06-14[2014-05-10].http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf.
[9] Eisenhauer EA,Therasse P,Bogaerts J,et al. New response evaluation criteria in solid tumours:revised RECIST guideline (version 1.1)[J].Eur J Cancer,2009,45(2):228-247.DOI:10.1016/j.ejca.2008.10.026.
[10] Mackie TR,Holmes T,Swerdloff S,et al. Tomotherapy:a new concept for the delivery of dynamic conformal radiotherapy[J].Med Phys,1993,20(6):1709-1719.DOI:10.1118/1.596958.
[11] Yu M,Lee JH,Jang HS,et al. A comparison of dosimetric parameters between tomotherapy and three-dimensional conformal radiotherapy in rectal cancer[J].Radiat Oncol,2013,8:181.DOI:10.1186/1748-717X-8-181.
[12] Cattaneo GM,Dell’oca I,Broggi S,et al. Treatment planning comparison between conformal radiotherapy and helical tomotherapy in the case of locally advanced-stage NSCLC[J].Radiother Oncol,2008,88(3):310-318.DOI:10.1016/j.radonc.2008.06.006.
[13] Kim S,Lee IJ,Kim YB,et al. A comparison of treatment plans using linac-based intensity-modulated radiation therapy and helical tomotherapy for maxillary sinus carcinoma[J].Technol Cancer Res Treat,2009,8(4):257-263.DOI:10.1177/153303460900800402.
[14] Hsieh CH,Liu CY,Shueng PW,et al. Comparison of coplanar and noncoplanar intensity-modulated radiation therapy and helical tomotherapy for hepatocellular carcinoma[J].Radiat Oncol,2010,5:40.DOI:10.1186/1748-717X-5-40.
[15] Lee TF,Chao PJ,Fang FM,et al. Helical tomotherapy for single and multiple liver tumours[J].Radiat Oncol,2010,5:58.DOI:10.1186/1748-717X-5-58.
[16] Lee IJ,Seong J,Koom WS,et al. Selection of the optimal radiotherapy technique for locally advanced hepatocellular carcinoma[J].Jpn J Clin Oncol,2011,41(7):882-829.DOI:10.1093/jjco/hyr053.
[17] Park HC,Seong J,Han KH,et al. Dose-response relationship in local radiotherapy for hepatocellular carcinoma[J].Int J Radiat Oncol Biol Phys,2002,54(1):150-155.DOI:10.1016/S0360-3016(02)02864-X.
[18] Kim JY,Yoo EJ,Jang JW.Hypofractionated radiotherapy using helical tomotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis[J].Radiat Oncol,2013,8:15.DOI:10.1186/1748-717X-8-15.
[19] Jang JW,Kay CS,You CR,et al. Simultaneous multitarget irradiation using helical tomotherapy for advanced hepatocellular carcinoma with multiple extrahepatic metastases[J].Int J Radiat Oncol Biol Phys,2009,74(2):412-418.DOI:10.1016/j.ijrobp.2008.08.034.
[20] Lee JH, Jang HS, Lee HC, et al. Hypofractionated radiotherapy with Tomotherapy for patients with hepatic oligometastases:retrospective analysis of two institutions. Clin Exp Metastasis 2013;30(5):643-650.DOI:10.1007/s10585-013-9568-7
[21] Yoon HI,Lee IJ,Han KH,et al. Improved oncologic outcomes with image guided intensity modulated radiation therapy using helical tomotherapy in locally advanced hepatocellular carcinoma[J].J Cancer Res Clin Oncol,2014,140(9):1595-1605.DOI:10.1007/s00432-014-1697-0.
[22] Zeng ZC,Fan J,Tang ZY,et al. A comparison of treatment combinations with and without radiotherapy for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombus[J].Int J Radiat Oncol Biol Phys,2005,61(2):432-443.DOI:10.1016/j.ijrobp.2004.05.025.