中国实用外科杂志2024，Vol.44Issue(9)：1027-1031,5.DOI:10.19538/j.cjps.issn1005-2208.2024.09.12
肝癌放疗获益人群筛选及方案选择
Selection of beneficiary populations and regimen choice in radiotherapy for hepatocellular carcinoma
摘要
Abstract
Radiotherapy is increasingly demonstrating its importance in the treatment of hepatocellular carcinoma(HCC),particularly across different stages of HCC.For patients with early and locally advanced HCC,techniques such as stereotactic body radiation therapy(SBRT)and intensity-modulated radiotherapy(IMRT)have matured,offering effective tumor control and improved survival outcomes.These techniques provide a promising treatment option for those who are not candidates for surgery or are unsuitable for radiofrequency ablation(RFA)and transarterial chemoembolization(TACE).In the treatment of intermediate to advanced HCC,radiotherapy can be integrated as part of local therapy and combined with systemic treatments to exert synergistic effects,further improving overall survival(OS)and progression-free survival(PFS).For instance,in patients with portal vein tumor thrombosis(PVTT),neoadjuvant radiotherapy can downstage tumors,rendering them resectable and reducing postoperative recurrence and complications.Radiotherapy also serves as an adjuvant therapy,particularly in patients with postoperative pathology indicating microvascular invasion(MVI)or narrow surgical margins,lowering the risk of local recurrence and prolonging disease-free survival(DFS).Additionally,for patients who do not meet liver transplantation criteria,radiotherapy can be utilized as a bridging therapy to downstage tumors,thereby making them eligible for transplantation and achieving favorable long-term survival rates post-transplantation.Overall,the application of radiotherapy in HCC treatment is expanding,especially when combined with targeted and immunotherapy,showing potential for enhanced efficacy.However,further high-quality randomized controlled trials are necessary to validate the effectiveness and safety of these strategies.关键词
肝细胞癌/放射治疗/立体定向放射治疗/调强放疗/门静脉癌栓/新辅助放疗/微血管侵犯/桥接治疗Key words
hepatocellular carcinoma/radiotherapy/stereo-tactic body radiotherapy/intensity-modulated radiotherapy/portal vein tumor thrombus/neoadjuvant radiotherapy/micro-vascular invasion/bridging therapy分类
医药卫生引用本文复制引用
郑晓宾,陈一兴,曾昭冲,杜世锁..肝癌放疗获益人群筛选及方案选择[J].中国实用外科杂志,2024,44(9):1027-1031,5.基金项目
国家自然科学基金面上项目(No.82373517,No.82073479) （No.82373517,No.82073479）
