- 期刊
External Beam Radiation Therapy for Inoperable Hepatocellular Carcinoma with Portal Vein Thrombosis
肝癌病患合併門脈侵犯之外部放射線治療
摘要
肝癌病患合併門脈侵犯栓塞的預後相當不好，且常造成肝內轉移及遠處轉移。因此我們嘗試使用外部放射線治療合併經肝動脈化學栓塞術來治療此類肝癌病患。從1991年1月至1996年12月共有41位肝癌病患合併門脈侵犯接受外部放射線治療合併經肝動脈化學栓塞，我們使用腹部超音波，電腦斷層以及血管攝影來決定照射部位，平均照射野的大小為6.6X7.1平方公分，總劑量為36至66葛雷，平均劑量為51.4葛雷，每次劑量為1.8至2.0葛雷。門脈侵犯栓塞部位接受治療的結果，39％完全消失，41％局部消失，19％無反應。從病患開始接受放射線治療開始算起，存活期中值為10個月，其中門脈侵犯栓塞部位完全消失的病患存活期中值為17個月，局部消失的病患存活期中值為8個月，無反應的病患存活期中值為4個月，多變異數分析結果存活期與門脈侵犯治療的反應有統計學上的意義（P=0.002），如此的治療並不會引起放射線肝炎。此初步結果，使用外部放射線治療照射門脈侵犯部位，值得更進一步研究。
關鍵字
無資料並列摘要
Portal vein thrombosis (PVT) in patients with hepatocellular carcinoma (HCC) has a poor impact on prognosis. Many of these tumors may cause intrahepatic and extrahepatic metastases. From January 1991 to December 1996,41 unresectable HCC patients with PVT underwent transcatheter arterial chemoembolization (T ACE) and external beam radiation therapy (EBRT) to the portion of PVT. The irradiated field, with a mean equivalent field size of 6.6x7 . lcm2, was localized and simulated by abdominal sonography, angiography and computed tomography. Radiation dose ranged from 36 to 66 Gy (mean dose: 51. 4 Gy), in a daily fraction of 1.8 to 2 Gy. The response of EBRT was evaluated by abdominal sonography within 3 months of completion of EBRT. The response rates of the PVT after treatment were 39% for complete response (CR), 41% or partial response (PR), and 19% for no response (NR), respectively. The median overall survival time from start of radiotherapy was 10 months for all patients, 17 months for CR patients, 8 months for PR patients and 4 months for NR patients. By multivariate analysis, response of PVT resulted in a significant improvement in survival. (P = 0.00l) There was no occurrence of severe complication of radiation-induced liver disease. The results obtained with combined treatment modality of EBRT and T ACE in the treatment of HCC patients with PVT are encouraging.
被引用紀錄
延伸閱讀
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