碳离子放疗作为肝细胞癌合并Child-Pugh B级肝硬化的局部治疗选择

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2025-05-17 DOI:10.1016/j.adro.2025.101812

Shintaro Shiba MD, PhD , Keisuke Tsuchida MD, PhD , Nobutaka Mizoguchi MD, PhD , Shohei Kawashiro MD, PhD , Satoshi Shima MD , Kio Kano MD , Kohei Okada MD, PhD , Hiroaki Koge MD , Tatsuya Okuda MD , Riho Kuzuu MD , Daisaku Yoshida MD, PhD , Hiroyuki Katoh MD, PhD

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引用次数: 0

摘要

目的脆弱的Child-Pugh B级肝细胞癌（HCC）患者的局部治疗策略尚不明确。在这项研究中，我们评估了碳离子放射治疗（CIRT）与CP-B治疗HCC的安全性和有效性。方法与材料对2017年3月至2023年6月期间连续接受CIRT治疗的15例CP-B HCC患者进行分析。采用Kaplan-Meier法计算生存概率和局部控制概率。治疗相关肝毒性定义为CIRT治疗后6个月内CP评分升高≥2分。结果CIRT术后中位随访时间为18.7个月。在CIRT登记时，患者的中位年龄为71岁。中位肿瘤大小为51 mm。11例患者的CP评分为7分，3例为8分，1例为9分。treatment-naïve和复发HCC患者分别为6例和9例。1年和2年总生存率分别为67%和50%。1年和2年局部控制率均为94%。1年和2年无进展生存率分别为67%和11%。4名患者（27%）出现了治疗相关的肝毒性。在急性期和晚期，没有患者出现3级或更高的毒性。结论总的来说，本研究显示CIRT治疗CP-B HCC的安全性和有效性。CIRT是肝癌伴CP-B的局部治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Carbon-Ion Radiotherapy as a Local Treatment Option for Hepatocellular Carcinoma With Child-Pugh Class B Cirrhosis

Purpose

The local treatment strategy for fragile patients with hepatocellular carcinoma (HCC) with Child-Pugh class B (CP-B) remains unclear. In this study, we evaluated the safety and efficacy of carbon-ion radiation therapy (CIRT) for HCC with CP-B.

Methods and Materials

Fifteen consecutive patients with HCC with CP-B who received CIRT between March 2017 and June 2023 were analyzed. Survival and local control probabilities were calculated using the Kaplan-Meier method. Treatment-related liver toxicities were defined as a ≥2-point increase in CP score within 6 months of CIRT.

Results

The median follow-up duration after CIRT was 18.7 months. The median age of patients at the time of registration for CIRT was 71 years. The median tumor size was 51 mm. Eleven patients had a CP score of 7, 3 had a score of 8, and 1 had a score of 9. The number of patients with treatment-naïve and recurrent HCC was 6 and 9, respectively. The 1- and 2-year overall survival rates were 67% and 50%, respectively. The 1- and 2-year local control rates were both 94%. The 1- and 2-year progression-free survival rates were 67% and 11%, respectively. Four patients (27%) experienced treatment-related liver toxicities. No patient developed grade 3 or higher toxicities during the acute and late phases.

Conclusions

Overall, this study showed the safety and efficacy of CIRT for HCC with CP-B. CIRT is a local treatment option for HCC with CP-B.

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来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.