JCO:立体定向放疗或将是非手术治疗肝细胞癌的**!

2015-12-03 zhaozhou 译 MedSci原创

 目前对于肝细胞癌(Hepatocellular carcinoma, HCC)的标准治疗方案是进行手术治疗,但是大多数HCC患者并不是适合接受手术治疗,而是接受非手术局部干预治疗。这些治疗方法包括了区域性动脉治疗和局部消融治疗,包括射频消融治疗(RFA)、立体定向放射治疗(SBRT)、经皮乙醇注射(PEI)、微波消融以及冷冻消融。 来自密歇根大学的研究人员对比了SBRT和RF

目前对于肝细胞癌(Hepatocellular carcinoma, HCC)的标准治疗方案是进行手术治疗,但是大多数HCC患者并不是适合接受手术治疗,而是接受非手术局部干预治疗。这些治疗方法包括了区域性动脉治疗和局部消融治疗,包括射频消融治疗(RFA)、立体定向放射治疗(SBRT)、经皮乙醇注射(PEI)、微波消融以及冷冻消融。
 

来自密歇根大学的研究人员对比了SBRT和RFA治疗HCC的结果,试图为临床非手术治疗HCC提供更多的依据。从2004年到2012年,研究人员共收集了224名不能动手术的、非转移性HCC患者的数据。其中161人接受了RFA,63人接受了SBRT治疗。对于每位患者,RFA和SBRT组的伤口的数量、潜在的肝病的类型和肿瘤大小(中位值,1.8 vs 2.2cm)是相似的。但是,SBRT组在治疗前的肝功能分级打分更低,甲胎蛋白水平更高、并且早前有过更多的肝指向性治疗。RFA和SBRT组的肿瘤一年和两年的局部无进展率(FFLP)分别为83.6%和80.2%对97.4%和83.8%。接受RFA治疗的患者的肿瘤大小FFLP预测值增加,而SBRT组则没有。对于大小超过两厘米的肿瘤,接受RFA治疗的病人的FFLP低于SBRT组。接受RFA治疗的患者的一年和两年后的总生存率分别为70%和53%,而接受SBRT治疗的患者则为74%和46%。
 
此项研究表明,RFA和SBRT这两种疗法均是治疗不能接受手术治疗的HCC的有效局部治疗选择。尽管这些数据是前瞻性的,但是SBRT很有可能成为非手术治疗HCC的一线疗法。

原始出处:

Daniel R. Wahl et al. Outcomes After Stereotactic Body Radiotherapy or Radiofrequency Ablation for Hepatocellular Carcinoma. Journal of Clinical Oncology. Published Ahead of Print on November 30, 2015 as 10.1200/JCO.2015.61.4925

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    2016-08-03 lidong40
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    2016-08-12 xjy02
  4. 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topicName=立体定向)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Sun Oct 30 02:56:00 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49767, encodeId=b7e449e676e, content=有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Dec 28 01:59:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49768, encodeId=bf7649e689e, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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topicId=null, topicList=[TopicDto(id=45937, encryptionId=d7674593e05, topicName=定向)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920637977772, createdName=liao1632, createdTime=Fri May 06 10:56:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45448, encodeId=2594454480f, content=尽管这些数据是前瞻性的,但是SBRT很有可能成为非手术治疗HCC的一线疗法, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4bfa83595, createdName=jetleo, createdTime=Thu Dec 10 13:27:00 CST 2015, time=2015-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290574, encodeId=fccb12905e430, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Sat Dec 05 06:56:00 CST 2015, time=2015-12-05, status=1, ipAttribution=)]
  5. 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topicId=null, topicList=[TopicDto(id=45937, encryptionId=d7674593e05, topicName=定向)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920637977772, createdName=liao1632, createdTime=Fri May 06 10:56:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45448, encodeId=2594454480f, content=尽管这些数据是前瞻性的,但是SBRT很有可能成为非手术治疗HCC的一线疗法, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4bfa83595, createdName=jetleo, createdTime=Thu Dec 10 13:27:00 CST 2015, time=2015-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290574, encodeId=fccb12905e430, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Sat Dec 05 06:56:00 CST 2015, time=2015-12-05, status=1, ipAttribution=)]
    2015-12-28 wzf990214

    有意思

    0

  6. 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topicName=立体定向)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Sun Oct 30 02:56:00 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49767, encodeId=b7e449e676e, content=有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Dec 28 01:59:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49768, encodeId=bf7649e689e, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Dec 28 01:59:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49075, encodeId=f731490e5d4, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 09:02:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1768992, encodeId=d7681e6899216, content=<a href='/topic/show?id=d7674593e05' target=_blank style='color:#2F92EE;'>#定向#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, 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=Fri May 06 10:56:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45448, encodeId=2594454480f, content=尽管这些数据是前瞻性的,但是SBRT很有可能成为非手术治疗HCC的一线疗法, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4bfa83595, createdName=jetleo, createdTime=Thu Dec 10 13:27:00 CST 2015, time=2015-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290574, encodeId=fccb12905e430, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Sat Dec 05 06:56:00 CST 2015, time=2015-12-05, status=1, ipAttribution=)]
    2015-12-28 wzf990214

    赞一个

    0

  7. 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topicName=立体定向)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Sun Oct 30 02:56:00 CST 2016, time=2016-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49767, encodeId=b7e449e676e, content=有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Dec 28 01:59:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49768, encodeId=bf7649e689e, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Dec 28 01:59:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49075, encodeId=f731490e5d4, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 09:02:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1768992, encodeId=d7681e6899216, content=<a href='/topic/show?id=d7674593e05' target=_blank style='color:#2F92EE;'>#定向#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, 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=Fri May 06 10:56:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45448, encodeId=2594454480f, content=尽管这些数据是前瞻性的,但是SBRT很有可能成为非手术治疗HCC的一线疗法, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4bfa83595, createdName=jetleo, createdTime=Thu Dec 10 13:27:00 CST 2015, time=2015-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290574, encodeId=fccb12905e430, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Sat Dec 05 06:56:00 CST 2015, time=2015-12-05, status=1, ipAttribution=)]
    2015-12-27 hixiaoluo

    好文章,值得收藏

    0

  8. 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authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Mon Dec 28 01:59:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49075, encodeId=f731490e5d4, content=好文章,值得收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sun Dec 27 09:02:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1768992, encodeId=d7681e6899216, content=<a href='/topic/show?id=d7674593e05' target=_blank style='color:#2F92EE;'>#定向#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, 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=Fri May 06 10:56:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45448, encodeId=2594454480f, content=尽管这些数据是前瞻性的,但是SBRT很有可能成为非手术治疗HCC的一线疗法, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4bfa83595, createdName=jetleo, createdTime=Thu Dec 10 13:27:00 CST 2015, time=2015-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290574, encodeId=fccb12905e430, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Sat Dec 05 06:56:00 CST 2015, time=2015-12-05, status=1, ipAttribution=)]
    2016-05-06 liao1632
  9. 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topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Sat Dec 05 06:56:00 CST 2015, time=2015-12-05, status=1, ipAttribution=)]
    2015-12-10 jetleo

    尽管这些数据是前瞻性的,但是SBRT很有可能成为非手术治疗HCC的一线疗法

    0

  10. 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