JCO:不可切除肝癌:局部射频消融or立体定向放疗?——一份美国国家癌症数据库的分析报告

2018-02-23 国际肝病编辑部 国际肝病

目前,能够指导肝细胞癌(HCC)最佳局部消融治疗的数据仍然缺乏,比较这些治疗方式的前瞻相关性数据更是有限。来自美国梅奥医学中心的研究者通过美国国家癌症数据库数据,比较了射频消融(RFA)与立体定向放疗(SBRT)的有效性,相关结果发表在近期J Clin Oncol杂志。

目前,能够指导肝细胞癌(HCC)最佳局部消融治疗的数据仍然缺乏,比较这些治疗方式的前瞻相关性数据更是有限。来自美国梅奥医学中心的研究者通过美国国家癌症数据库数据,比较了射频消融(RFA)与立体定向放疗(SBRT)的有效性,相关结果发表在近期J Clin Oncol杂志。

这是一项观察性的研究,比较了非手术的I期或II期肝癌患者接受RFA和SBRT的疗效。根据患者方面、机构方面和肿瘤水平的特点,采用倾向评分加权和倾向评分匹配分析比较患者的总生存率。采用敏感性分析评估对严重肝纤维化/肝硬化的作用。此外,研究者还进行了在临床相关亚组中进行了探索性的分析,来确定RFA和SBRT的有效性。

结果发现,分别有3684例(92.6%)和296例(7.4%)非手术治疗的I期或II期肝癌患者接受了RFA或SBRT治疗。倾向匹配后,5年总体生存率为RFA组29.8%(95%CI:24.5%~35.3%),SBRT组19.3%(95%CI:13.5%~25.9%,P<0.001)。采用逆处理概率加权分析也得出类似结果。RFA的益处在所有的亚组中都是一致的,并且对伴有严重纤维化/肝硬化的患者影响很大。

该研究结果表明,对于非手术的I期或II期肝癌患者,RFA治疗患者的生存优于SBRT治疗。研究者强调:“尽管我们的研究结果受到与回顾性研究设计相关的偏见的限制,但我们认为,在没有随机临床试验的情况下,应根据此研究结果建议局部不可切除的HCC行局部消融治疗。”

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    2018-07-24 lidong40
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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Thu Mar 01 17:29:33 CST 2018, time=2018-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1769035, encodeId=f9b71e6903534, content=<a href='/topic/show?id=d7674593e05' target=_blank style='color:#2F92EE;'>#定向#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45937, encryptionId=d7674593e05, topicName=定向)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920637977772, createdName=liao1632, createdTime=Tue Jun 26 00:40:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279933, encodeId=bfcd12e9933bd, content=<a href='/topic/show?id=0b0546822fd' target=_blank style='color:#2F92EE;'>#射频消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46822, encryptionId=0b0546822fd, topicName=射频消融)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Feb 25 09:40:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405811, encodeId=940f140581102, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Sun Feb 25 09:40:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421706, encodeId=64861421e06f7, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sun Feb 25 09:40:00 CST 2018, time=2018-02-25, status=1, ipAttribution=)]
    2018-04-04 owlhealth

    不错耶.学习了

    0

  5. 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GetPortalCommentsPageByObjectIdResponse(id=1421706, encodeId=64861421e06f7, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sun Feb 25 09:40:00 CST 2018, time=2018-02-25, status=1, ipAttribution=)]
    2018-03-14 wxl882001

    了解一下

    0

  6. 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style='color:#2F92EE;'>#射频消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46822, encryptionId=0b0546822fd, topicName=射频消融)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Feb 25 09:40:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405811, encodeId=940f140581102, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Sun Feb 25 09:40:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421706, encodeId=64861421e06f7, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sun Feb 25 09:40:00 CST 2018, time=2018-02-25, status=1, ipAttribution=)]
    2018-03-01 wxl882001

    学习一下

    0

  7. 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GetPortalCommentsPageByObjectIdResponse(id=1421706, encodeId=64861421e06f7, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sun Feb 25 09:40:00 CST 2018, time=2018-02-25, status=1, ipAttribution=)]
    2018-06-26 liao1632
  8. 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    2018-02-25 chg122
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Dev Cell:研究发现肝癌的“天敌”,或将解决长期以来克制肝癌的难题!

美国西南部的儿童医学中心研究中心的研究人员发现,全基因组复制的肝脏细胞,即多倍体细胞,可以保护肝脏不受癌症侵袭。这项研究发表在《发育细胞》(Developmental Cell)网站上。该研究解决了一个长期存在的关于肝脏生物学的谜题,可以激发新的想法来预防癌症。

GUT:钇-90放射性栓塞对肝癌治疗的免疫学影响!

钇-90(Y90)-放射性栓塞(RE)可以显着地消退局部晚期肝细胞癌并延缓疾病进展。近期,一项发表在杂志GUT上的研究旨在深入探讨引起持续治疗反应的Y90-RE的免疫学影响。此项研究采用飞行时间质谱法和下一代测序技术(NGS)分析在Y90-RE前后不同时间点肿瘤浸润白细胞(TILs)、肿瘤组织和外周血单个核细胞(PBMCs)的免疫表型。此项研究结果显示:Y90-RE后分离的TILs表现出局部免疫激