质子放射治疗原发性肝细胞癌的疗效、安全性及影响因素分析  

Analysis of the efficacy and safety of proton radiotherapy for primary hepatocellular carcinoma

作　　者：乔纲 郑丽丽 任茜[1] 陈庆[2] 穆向魁 Qiao Gang;Zheng Lili;Ren Xi;Chen Qing;Mu Xiangkui(Zibo Wanjie Cancer Hospital,Zibo 255213,China;Zibo Wanjie Cancer Hospital Proton Therapy Center,Zibo 255213,China;Shandong Cancer Hospital Proton Clinical Research Center,Jinan 250117,China)

机构地区：[1]淄博万杰肿瘤医院,淄博255213 [2]淄博万杰肿瘤医院质子治疗中心,淄博255213 [3]山东省肿瘤医院质子临床研究中心,济南250117

出　　处：《国际生物医学工程杂志》2023年第2期128-131,共4页International Journal of Biomedical Engineering

摘　　要：目的研究质子放射治疗原发性肝细胞癌(HCC)的疗效、安全性及影响生存的预后因素。方法选取2005年6月15日至2018年9月12日山东淄博万杰肿瘤医院原发性肝细胞癌患者44例,给予质子放射治疗,单次剂量2~5 Gy,总剂量25~75 Gy。随访12~120个月,观察患者的总生存率和局部控制率、生存影响因素以及不良反应。结果所有患者1年的总生存率为79.5%、2年为68.2%、3年为50.0%、5年为45.5%;总局部控制率为95.5%。超过50岁患者具有更长的总体生存期(Log Rank Chi-Square=4.787,P=0.029);分期的高低,对生存无影响;Child-Pugh A分级相比B分级总体生存更优(Log Rank Chi-Square=4.077,P=0.043)。主要不良反应为皮肤反应和胃肠道反应,23例患者出现皮肤反应,9例出现轻微胃肠道反应,未发现严重不良事件。结论质子放射治疗对HCC患者有较好疗效,且安全性较高;年龄和Child-Pugh分级是影响质子放射治疗后生存期的预后因素。Objective To study the efficacy,safety and prognostic factors affecting survival of proton radiation therapy for primary hepatocellular carcinoma(HCC).Methods Forty-four patients with primary hepatocellular carcinoma treated at Zibo Wanjie Cancer Hospital in Shandong Province from June 15,2005 to September 12,2018 were enrolled and given proton radiation therapy with a single dose of 2-5 Gy and a total dose of 25-75 Gy.The overall and local control rates,factors influencing survival,and adverse effects were observed during a follow-up period of 12 to 120 months.Results The overall survival rates of all patients were 79.5%at 1 year,68.2%at 2 years,50.0%at 3 years,and 45.5%at 5 years.The overall local control rate was 95.5%.Patients older than 50 years had a longer overall survival(Log Rank Chi-Square of 4.787,P=0.029).Child-Pugh A classification had better overall survival compared with B classification(Log Rank Chi-Square 4.077,P=0.043).The main adverse reactions were skin reactions and gastrointestinal reactions.Among the patients with adverse reactions,23 patients had skin reactions and 9 patients had mild gastrointestinal reactions,and no serious adverse events were found.Conclusions Proton radiation therapy has good efficacy and high safety in patients with HCC.Age and Child-Pugh classification are prognostic factors affecting survival after proton radiation therapy.

关 键 词：质子放射治疗 原发性肝细胞癌 生存率 局部控制率 

分 类 号：R735.7[医药卫生—肿瘤]