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首页> 外文期刊>BMC Cancer >Hypofractionated radiotherapy as a salvage treatment for recurrent hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus: a multi-center analysis
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Hypofractionated radiotherapy as a salvage treatment for recurrent hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus: a multi-center analysis

机译：次谐波放射治疗作为经常性肝细胞癌的抢救治疗，下腔静脉/右心房肿瘤血栓：多中心分析

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Recurrent hepatocellular carcinoma (HCC) with a tumor thrombus (TT) extending into the inferior vena cava (IVC)/right atrium (RA) is generally regarded as a terminal-stage condition and there is no worldwide consensus on the proper management of this situation. In the present study, we report the efficacy of hypofractionated radiotherapy (HFRT) as a salvage treatment for recurrent HCC with IVC/RA TT. We retrospectively reviewed 75 HCC patients with an IVC/RA TT who were referred for HFRT at three institutions between 2008 and 2016. 57 cases had a TT located in the IVC (IVC group), and 18 cases had a TT located in the IVC and RA (IVC?+?RA group). HFRT was designed to focus on the TT with or without the primary intrahepatic tumors. In all cases, the TT completely disappeared (CR) in 17 patients (22.7%), 55 patients (73.3%) had a partial response (PR), and 3 patients (4.0%) had a stable disease (SD). There were no cases of progressive disease (PD). The 1-, 2-, and 3-year overall survival rates of the 75 patients were 38.7% (29/75), 13.3% (10/75) and 5.3% (4/75), respectively. The overall median survival time was 10?months. The mean survival times for the IVC group and IVC+ RA group were 13.8?±?1.1 and 11.6?±?2.5?months, respectively. There was no significant difference in survival between the two groups (p?=?0.205). Log-rank test revealed that factors predicting poor survival were Child-Pugh B liver function classification, AFP?≥?400?μg/L, intrahepatic multiple tumors, distant metastases, only the TT as the target, a biological effective dose (BED)??55?Gy and no chance of further radiotherapy. HFRT appears to be an effective and reasonable treatment option for recurrent HCC patients with IVC/RA TT. The location of the tumor thrombus, either in IVC or in IVC and RA, is not the factor that influences the efficacy of radiotherapy or survival.
机译：与延伸到下腔静脉（IVC）/右心房（RA）的肿瘤血栓癌（HCC）通常被认为是终端阶段条件，并且没有全世界关于这种情况的适当管理的共识。在本研究中，我们报告了低次级放射疗法（HFRT）作为具有IVC / Ra TT的复发治疗的救生处理的疗效。我们回顾性地审查了75名HCC患者，其中有一个IVC / RA TT在2008年至2016年间三个机构提交的IVC / RA TT。57例患者位于IVC（IVC集团）中，18例患有IVC的TT和TT RA（IVC？+？RA组）。 HFRT设计用于专注于具有或不具有主要肝内肿瘤的TT。在所有情况下，17名患者的TT完全消失（CR）（22.7％），55名患者（73.3％）有部分反应（PR），3例患者（4.0％）具有稳定的疾病（SD）。没有渐进疾病（PD）。 75名患者的1-，2-和3年的总存活率分别为38.7％（29/75），13.3％（10/75）和5.3％（4/75）。整体中位生存时间为10？几个月。 IVC组和IVC + RA组的平均存活时间分别为13.8？±1.1和11.6？±2.5​​？数月。两组之间存活率没有显着差异（p？= 0.205）。日志秩测试显示，预测生存率差的因素是儿童-PUGH B肝功能分类，AFP？≥？400？μg/ L，肝内多肿瘤，远处转移，只有TT作为靶，生物有效剂量（床） ？<？55？GY，没有进一步放疗的机会。 HFRT似乎是具有IVC / RA TT的经常性HCC患者的有效合理的治疗选择。肿瘤血栓的位置在IVC或IVC和RA中，不是影响放射治疗或存活的疗效的因素。

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