A Non-invasive Weapon: Image-guided Radiotherapy for Hepatocellular Carcinoma
ALY Law, WT Ng, SYJ Ka, RMW Yeung
Hong Kong J Radiol 2012;15(Suppl):S29-32
The high prevalence of chronic hepatitis B virus infection in Hong Kong makes hepatocellular carcinoma one of the area’s most important solid tumours. Late presentation and underlying cirrhosis mean that many hepatocellular carcinomas are inoperable at first presentation. For many years, radiotherapy was a poor option for inoperable hepatocellular carcinoma because of low hepatic tolerance of radiation and technical limitations in the delivery of radiotherapy. A variety of technological advances in the areas of diagnostic imaging, radiotherapy planning, motion management, and image guidance during radiotherapy delivery have overcome most of the barriers to effective application of radiotherapy in hepatocellular carcinoma. In the Department of Clinical Oncology at Pamela Youde Nethersole Eastern Hospital, image-guided radiotherapy has achieved excellent results in 59 patients with liver-confined hepatocellular carcinoma, and the treatment is well tolerated. The oneyear local control rate and one-year overall survival rate were 91% and 71%, respectively. Our experience and other published data indicate that image-guided radiotherapy can be considered the treatment of choice for patients with hepatocellular carcinoma who prefer non-surgical intervention.
中文摘要
一種非侵入性武器：影像引導放射治療肝癌
羅麗柔、吳偉棠、賈亦尊、楊美雲
在香港，慢性乙型肝炎病毒感染的高患病率使肝癌成為本地最重要的實體腫瘤之一。遲診及伴有不 同程度的肝硬化令很多肝癌病例在診症時已無法用手術治療。多年來，由於肝臟細胞對輻射的抵受 力度低，以及傳送放射治療的技術困難，放射治療對於無法用手術切除的肝細胞癌來說並不是一個 好的選擇。隨著科技的進步，診斷成像、放射治療計劃、移動管理、放療期間的圖像引導各種技術 經已跨越障礙，令放射治療可以應用在肝癌上。東區尤德夫人那打素醫院的臨床腫瘤科利用影像 引導放射治療，替59名癌細胞局限在肝臟的病人進行治療，並取得極佳的效果，病人耐受性亦相當 好：一年局部控制率為91%，一年存活率為71%。我們的經驗和其他公佈的數據均顯示，圖像引導 放射治療可以是那些選擇非手術介入治療的肝癌患者的首選療法。