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在肝细胞癌的五分体立体体辐射疗法中,剂量与局部控制之间的关系

Yuta Nishikawa^1,2, Ichiro Ogino³, Yuki Mukai³

¹Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan; nishikawa.yut.rl@yokohama-cu.ac.jp.

In vivo (Athens, Greece)

|August 28, 2025

概括

对于接受静态体辐射疗法 (SBRT) 的肝细胞癌 (HCC) 患者,最低剂量覆盖计划目标体积的95% (PTV D95%) 对于局部控制至关重要. 达到至少40 Gy的PTV D95%可以防止复发.

科学领域:

辐射瘤学
肝细胞癌研究
临床剂量测量

背景情况:

立体放射疗法 (SBRT) 是肝细胞癌 (HCC) 的有效治疗方法.
在接受SBRT治疗的HCC患者中,优化辐射剂量对实现局部控制 (LC) 和最小化毒性至关重要.
覆盖计划目标体积95%的最小剂量 (PTV D95%) 是可能影响治疗结果的关键剂量参数.

研究的目的:

在接受SBRT治疗的肝细胞癌 (HCC) 患者中,研究计划目标体积 (PTV D95%) 与局部控制 (LC) 之间的关联.
确定最佳的PTV D95%值,以防止HCC患者的局部复发.

主要方法:

在接受五分SBRT (30-50 Gy) 的59名患者中对72个HCC瘤进行了回顾性分析.
评估局部控制 (LC) 率和与最低剂量的相关性,覆盖计划目标体积的95% (PTV D95%).
进行了单变量,多变量和受体操作特征 (ROC) 分析,以确定PTV D95%的预后意义.

主要成果:

随访时间的中位数为20个月,1年的LC率为93. 7%,2年的LC率为82. 3%.
在单变量和多变量分析中,PTV D95%是LC的显著预后因素 (p<0. 05).
在接受PTV D95% ≥40 Gy的患者中没有观察到局部复发,并且确定38 Gy是预防复发的最佳切断剂量.

结论:

在用SBRT治疗的HCC患者中,最低剂量覆盖95%的计划目标体积 (PTV D95%) 是局部控制 (LC) 的重要预测指标.
在接受五分SBRT治疗的HCC患者中,建议PTV D95%为40 Gy或更高的目标剂量,以改善局部控制和预防复发.

关键词:

立体辐射疗法肝细胞癌辐射剂量

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