肝癌门静脉肿瘤血栓肿瘤反应的观察研究。

IF 0.7 Q4 SURGERY Journal of radiosurgery and SBRT Pub Date : 2022-01-01
Prateek Mehra, Tejinder Kataria, Deepak Gupta, Sonal Krishan
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引用次数: 0

摘要

目的:立体定向放射治疗(SBRT)能对门静脉肿瘤血栓(PVTT)进行消毒,使患者符合肝移植的条件。我们评估了SBRT后PVTT的放射学反应,并检查了辐射性肝病(RILD)的发生率。方法:根据mRECIST标准,观察PVTT治疗4-6周后的疗效、PVTT体积及动脉期PVTT增强情况。评估生化数据和Child-Pugh评分(CPC)来确定RILD的发生率。结果:纳入31例患者。完全缓解5例(16.1%),部分缓解13例(41.9%),病情稳定12例(38.7%)。SBRT前PVTT平均体积为15.05 cc, SBRT后为7.83 cc (p = 0.001)。SBRT前病变平均增强为86.19HU,而SBRT后病变平均增强为58.58HU (p = 0.000)。2例患者出现3级不良事件。结论:SBRT后PVTT体积、增强、长轴长度均有统计学意义的改善。SBRT后无一例发生RILD。
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An observational study on tumour response of portal vein tumour thrombus in hepatocellular carcinoma.

Objectives: Stereotactic body radiotherapy (SBRT) can sterilize the portal vein tumour thrombus (PVTT) and may make the patient eligible for liver transplant. We assessed the radiological response of PVTT after SBRT and check incidence of radiation induced liver disease (RILD).

Methods: PVTT treatment response was measured at 4-6 weeks as per mRECIST criteria, volume of PVTT and its enhancement in arterial phase. Biochemical data and Child-Pugh scoring (CPC) were evaluated to determine RILD incidence.

Results: 31 Patients were included. Complete response was seen in 5 patients (16.1%), partial response in 13 patients (41.9%), stable disease in 12 patients (38.7%). Mean volume of PVTT was 15.05 cc before SBRT and 7.83 cc afterwards (p = 0.001). The mean enhancement of the lesion was 86.19HU before SBRT vs 58.58HU after SBRT (p = 0.000). Two patients had grade 3 adverse events.

Conclusion: Volume, enhancement, and major axis length of PVTT showed statistically significant improvement after SBRT. No case had RILD after SBRT.

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