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頁籤選單縮合
題名 | Preliminary Results of Three-dimensional Conformal Radiotherapy for Hepatocellular Carcinoma with Portal Vein Thrombosis=三度空間順形放射治療對肝癌合併肝門靜脈栓塞之初步成果 |
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作者 | 許維中; 王博民; 英恭史; 趙哲仁; 黃仁杰; 林高德; | 書刊名 | 中華放射線醫學雜誌 |
卷期 | 27:2 2002.04[民91.04] |
頁次 | 頁59-66 |
分類號 | 416.246 |
關鍵詞 | 順形放射治療; 肝癌; 肝門靜脈栓塞; Conformal radiotherapy; Hepatocellular carcinoma; Portal vein thrombosis; |
語文 | 英文(English) |
中文摘要 | 本文目的欲以評做三度空間順形放射治療對肝癌合併肝門靜脈栓塞之反應與治療成效。從1998年10月至2000年9月,24位肝癌合併肝門靜栓塞的病患實行三度空間順形放射治療。病患平均年齡為54.1歲(從30至73歲),平均追蹤日數為265天(從68至689天)。三度空間順形放射治療利用6至10百萬伏特光子射線,以每週5天,每天一次,每次1.8至2戈雷,總劑量43.2至75戈雷之方式施行。平均治療體積為455.76毫升(從62.39至1436.76毫升)。一般而言,病患接受三度空間順形放射治療後的反應良好(63%,15/24)。利用多變項分析,肝內或肝外侵犯是影響肝門靜脈栓塞反應的唯一顯著因子(p=0.025)。180天和360天之存活率分別為72.0%和55.4%,中位存活時間為215.5天。使用多變項存活分析之Cox’s迴歸模式,發現治療劑量(p=0.011)、肝內或肝外侵犯(p=0.041)和治療體積(p=0.032)影響預後。當治療體積分為小於500毫升及等於或大於500毫升時,存活曲線有統計意義(p=0.029)。放射引起的急性副作用,包括:白血球降低、暫時肝功能障礙和上腹痛,均屬輕微且可逆。我們的經驗指出對無法切除之肝癌合併肝門靜脈栓塞之病患,三度空間順形放射治療是安全有效之治療模式。初步資料顯示研究三度空間順形放射治療在不同期別之肝癌的治療策略所扮演的角色是極具價值且有成功的希望。 |
英文摘要 | The Purpose of this work is to evaluate the response and therapeutic results of hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) treated with 3Dimensional (3-D) conformal radiotherapy (RT). Twenty-four HCC patients with PVT who had been treated with 3-D conformal RT from October 1998 to September 2000 were reviewed. The mean age was 54.1 years old (range 30-73 years old). Patients had the mean follow-up period of 265 days (range 68-689 days). Three-dimensional conformal RT was delivered using 6 or10 MV photons at 1.8- 2 Gy per fraction, once a day on 5 days of the week for a total dose of 43.2- 75 Gy. The mean treatment volume was 455.76 ml (ranged 62.391436.76 ml). In general, the HCC patients with PVT who received 3-D conformal RT had good responses (63%, 15/24). By multivariate analysis, intrahepatic or extrahepatic involvement was the only significant factor that influenced the response of PVT (p=0.025). The 180 and 360 days survival rates were 72.0% and 55.4%. The median survival time was 215.5 days. Using Cox's regression model for multivariate survival analysis, treatment dose (p=0.011), intrahepatic or extrahepatic involvement (p=0.041) and treatment volume (p=0.032) were found to affect the prognosis. When treatment volume was divided into less than 500 ml and equal or more than 500 ml subgroups, the survival curves showed statistical significance (p=0.029). Radiation-induced acute complications, including leukopenia, transient liver dysfunction, and epigastralgia, were mild and reversible. Our experience concludes that 3-D conformal RT may be a safe and effective treatment modality for unresectable HCC patients with PVT. The preliminary data shows quite promising and it is valuable to study the potential role of 3-D conformal RT in the treatment strategy for HCC at various stages. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。