[Therapeutic factors related to irradiation in primary and metastatic liver cancer using multivariate analysis].

Nihon Gan Chiryo Gakkai shi Pub Date : 1990-06-20
K Hatano
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Abstract

Between December 1973 and August 1987, 21 patients with primary liver cancer and 41 patients with metastatic liver cancer were treated with external irradiation, intra-arterial infusion chemotherapy and/or trans-arterial embolization (TAE) at the National Medical Center Hospital, the National South Kyushu Central Hospital and the National Kure Hospital. They were all inoperable cases. We diagnosed the tumor site and the involved area with many imagings and we decided the target volume. 1. Primary liver cancer: the average survival period was 10.9 months, the 1-year survival rate was 28.6%, the 2-year survival rate was 14.3% and the 3-year survival rate was 4.7%. Using multivariate analysis, stage, cancer reduction rate, Child classification and field size were valuable factors of the prognosis in the arterial infusion group. In the TAE group, cancer reduction rate was the most valuable factor. 2. Metastatic liver cancer: The average survival period was 8.0 months, the 1-year survival rate was 19.5%, the 5-year survival rate was 2.4%. Using multivariate analysis, pre-treatment K.P.S, distant metastasis, H, Child classification were valuable factors and pre-treatment K.P.S. was most valuable factor. Although the indication of hepatic irradiation were generally thought to limit those cases which were Child A or B, H1 or H2 and the cases which have no distant metastasis, the case which have their main portal tumor thrombus were also the indication of this therapy.

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[多因素分析与原发性和转移性肝癌放疗相关的治疗因素]。
在1973年12月至1987年8月期间,21名原发性肝癌患者和41名转移性肝癌患者在国立医疗中心医院、国立南九州中心医院和国立Kure医院接受了外照射、动脉内输注化疗和/或经动脉栓塞(TAE)治疗。他们都是无法手术的病例。我们通过许多影像来诊断肿瘤部位和受累区域,并确定目标体积。1. 原发性肝癌:平均生存期10.9个月,1年生存率28.6%,2年生存率14.3%,3年生存率4.7%。多因素分析发现,动脉输注组的分期、肿瘤减少率、Child分型及野区大小是影响预后的重要因素。在TAE组中,减癌率是最有价值的因素。2. 转移性肝癌:平均生存期8.0个月,1年生存率19.5%,5年生存率2.4%。多因素分析发现,治疗前K.P.S.、远处转移、H、Child分型是有价值的因素,治疗前K.P.S.是最有价值的因素。虽然一般认为肝照射的适应症仅限于Child A或B、H1或H2以及无远处转移的病例,但有主要门静脉肿瘤血栓的病例也是肝照射的适应症。
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