（伽玛刀)SBRT_美国最新多中心结果

针对HCC和ICC

Multicenter results of stereotactic body radiotherapy (SBRT) for non-resectable primary liver tumors

May 2012, Vol. 51, No. 5 , Pages 575-583 (doi:10.3109/0284186X.2011.652736)
HTML PDF (146 KB) PDF Plus (146 KB) Reprints PermissionsRafael A. Ibarra1, Daniel Rojas1, Laura Snyder1, Min Yao3, Jeffrey Fabien3, Michael Milano4, Alan Katz4, Karyn Goodman5, Kevin Stephans6, Galal El-Gazzaz6, Federico Aucejo6, Charles Miller6, John Fung6, Simon Lo3, Mitchell Machtay3 & Juan R. Sanabria1
1Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio, USA
2Department of Medicine, University Hospitals-Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
3Department of Radiation Oncology, University Hospitals-Case Medical Center, Cleveland, Ohio, USA
4University of Rochester Medical Center, Rochester, New York, USA
5Memorial Sloan-Kettering Cancer Center, New York
6Cleveland Clinic, Case Western Reserve University & Lerner College of Medicine, Cleveland, OH
Correspondence: J.R. Sanabria, Division of Transplant and Hepatobiliary Surgery, Department of Surgery, University Hospitals-Case Medical Center, 11100 Euclid Avenue, Lakeside 7506, PS 5047, Cleveland 44106, Ohio, USA. Tel: + 1 216 8443138. Fax: + 1 216 8445398. E-mail: juan.sanabria@uhhospitals.org or juan.sanabria@case.edu




Abstract
Background. An excess of 100 000 individuals are diagnosed with primary liver tumors every year in USA but less than 20% of those patients are amenable to definitive surgical management due to advanced local disease or comorbidities. Local therapies to arrest tumor growth have limited response and have shown no improvement on patient survival. Stereotactic body radiotherapy (SBRT) has emerged as an alternative local ablative therapy. The purpose of this study was to evaluate the tumor response to SBRT in a combined multicenter database. Study design. Patients with advanced hepatocellular carcinoma (HCC, n = 21) or intrahepatic cholangiocarcinoma (ICC, n = 11) treated with SBRT from four Academic Medical Centers were entered into a common database. Statistical analyses were performed for freedom from local progression (FFLP) and patient survival. Results. The overall FFLP for advanced HCC was 63% at a median follow-up of 12.9 months. Median tumor volume decreased from 334.2 to 135 cm3 (p < 0.004). The median time to local progression was 6.3 months. The 1- and 2-years overall survival rates were 87% and 55%, respectively. Patients with ICC had an overall FFLP of 55.5% at a median follow-up of 7.8 months. The median time to local progression was 4.2 months and the six-month and one-year overall survival rates were 75% and 45%, respectively. The incidence of grade 1–2 toxicities, mostly nausea and fatigue, was 39.5%. Grade 3 and 4 toxicities were present in two and one patients, respectively. Conclusion. Higher rates of FFLP were achieved by SBRT in the treatment of primary liver malignancies with low toxicity.

SBRT：体部立体定向放射治疗（伽玛刀即是SBRT的一种)

ICC 11例。
中值随访期7.8月，无局部进展（FFLP）占55.5%.
局部进展期的中值为4.2月。
六月、一年的生存期分别为75%，45%