PDF(Pubmed)
Abstract：
Centrally located hepatocellular carcinoma (HCC) is difficult to be radically resected due to its special location close to major hepatic vessels. Thus, we aimed to assess whether stereotactic body radiation therapy (SBRT) can be an effective and safe approach for centrally located HCC. This retrospective study included 172 patients with centrally located HCC who were treated with SBRT. Overall survival (OS) was analyzed as the primary endpoint. Rates of progression-free survival (PFS), local control, intrahepatic relapse, extrahepatic metastasis and toxicities were analyzed as secondary endpoints. The OS rates of 1-, 3-, and 5-year were 97.7%, 86.7%, and 76.3%, respectively. The PFS/local control rates of 1-, 3-, and 5-year were 94.1%/98.2%, 76.8%/94.9%, and 59.3%/92.3%, respectively. The cumulative incidence of intrahepatic relapse/extrahepatic metastases of 1-, 3-, and 5-year were 3.7%/2.9%, 25.0%/7.4%, and 33.3%/9.8%, respectively. Both univariate and multivariate analyses revealed that patients received BED10 at 100 Gy or more had better OS. Radiation-related adverse events were mild to moderate according to Common Terminology Criteria for Adverse Events, and no toxicities over grade 3 were observed. Patients with centrally located HCC in our cohort who received SBRT had similar OS and PFS rates compared to those reported in literatures who received surgery with neoadjuvant or adjuvant intensity-modulated radiation therapy. These results indicate that SBRT is an effective and well-tolerated method for patients with centrally located HCC, suggesting that it may serve as a reasonable alternative treatment for these kind of patients.
摘要：
位于中央的肝细胞癌（HCC）由于其靠近主要肝血管的特殊位置而难以彻底切除。因此，我们的目的是评估立体定向放射治疗(SBRT)对于位于中央的HCC是否是一种有效和安全的方法.这项回顾性研究包括172例接受SBRT治疗的中央HCC患者。分析总生存期(OS)作为主要终点。无进展生存率（PFS），本地控制,肝内复发,肝外转移和毒性作为次要终点进行分析.操作系统速率为1-，3-,5年期为97.7%，86.7%,76.3%,分别。PFS/局部控制率为1-，3-,5年期分别为94.1%/98.2%，76.8%/94.9%，和59.3%/92.3%，分别。1-肝内复发/肝外转移的累积发生率，3-,5年期分别为3.7%/2.9%，25.0%/7.4%，和33.3%/9.8%，分别。单变量和多变量分析均显示，接受100Gy或更多BED10的患者具有更好的OS。根据不良事件通用术语标准，辐射相关不良事件为轻度至中度，并且没有观察到超过3级的毒性。与接受新辅助或辅助调强放疗手术的文献报道相比，接受SBRT的中心位置HCC患者具有相似的OS和PFS率。这些结果表明，SBRT是一个有效的和耐受性良好的方法为患者中心定位肝癌。这表明它可以作为这类患者的合理替代疗法。
