三维适形放射治疗不同大体肿瘤体积的原发性肝癌患者疗效研究*

doi:10.3969/j.issn.1672-5069.2022.05.026

实用肝脏病杂志 ›› 2022, Vol. 25 ›› Issue (5): 710-713.doi: 10.3969/j.issn.1672-5069.2022.05.026

三维适形放射治疗不同大体肿瘤体积的原发性肝癌患者疗效研究^*

张凯, 刘培培, 饶石磊, 王琦, 岳恺, 王旸, 杨峥, 张松

473000 河南省南阳市中心医院放疗科(张凯,饶石磊,王琦,王旸,杨峥);呼吸与危重症医学科二病区(刘培培);肿瘤内科三病区(岳恺);郑州大学第一附属医院放疗科(张松)

收稿日期:2022-01-28 出版日期:2022-09-10 发布日期:2022-09-22
通讯作者: 杨峥,E-mail:dryangzheng@163.com
作者简介:张凯,男,36岁,医学硕士,主治医师。研究方向:恶性肿瘤的基础与临床研究。E-mail:zhangkai211213@163.com
基金资助:
河南省医学科技攻关计划项目(编号:LHGJ20190489)

Survival rates in patients with primary liver cancer and different gross tumor volumes after radiotherapy

Zhang Kai, Liu Peipei, Rao Shilei, et al.

Department of Radiotherapy, Central Hospital, Nanyang 473000,Henan Province,China

Received:2022-01-28 Online:2022-09-10 Published:2022-09-22

摘要/Abstract

摘要： 目的探讨不同大体肿瘤体积(GTV)的原发性肝癌(PLC)患者放射治疗后生存情况。方法 2018年1月～2020年12月我院收治的PLC患者75例,根据GTV的不同将患者分为A组(＜125 cm³)20例、B组(126～999 cm³)37例和C组(＞1000 cm³)18例,均接受三维适形放射治疗(3DCRT)。采用ELISA法检测血清甲胎蛋白(AFP)、甲胎蛋白异质体L3(AFP-L3)、高尔基体糖蛋白73(GP73)、血管内皮生长因子(VEGF)和基质金属蛋白酶(MMP)水平。结果在治疗后4 w末,A组客观缓解率(ORR)为70.0%,显著高于B组的51.4%或C组的33.3%(P＜0.05);A组血清AFP、AFP-L3、GP73、VEGF和MMP水平分别为(121.0±20.8)ng/mL、(5.9±0.9)ng/mL、(62.8±3.5)ng/mL、(265.3±20.4)pg/mL和(60.2±11.7)ng/L,显著低于B组【分别为(133.0±18.1)ng/mL、(6.5±0.7)ng/mL、(71.4±3.2)ng/mL、(296.1±30.9)pg/mL和(72.5±7.3)ng/L,P＜0.05】或C组【分别为(143.0±15.3)ng/mL、(6.9±0.8)ng/mL、(78.3±3.7)ng/mL、(320.5±32.7)pg/mL和(85.5±15.6)ng/L,P＜0.05】;A组1 a累积生存率为72.2%(13/18),显著高于B组的52.9%(18/34)或C组的41.2%(7/17,P＜0.05)。结论采用3DCRT治疗PLC患者近期有效,但需考虑GTV的影响,GTV越小,近期疗效越好,值得进一步研究。

关键词: 原发性肝癌, 三维适形放射治疗, 大体肿瘤体积, 生存

Abstract: Objective The aim of this study was to investigate the survival of patients with primary liver cancer (PLC) and different gross tumor volume (GTV) after radiotherapy three-dimensional conformal radiotherapy (3DCRT). Methods 75 patients with PLC were encountered in our hospital between January 2018 and December 2020, and were divided into group A (n=20,< 125 cm³), group B (n=37,126-999 cm³) and group C (n=18,>1000 cm³) based on different GTV. All patients received 3DCRT. Serum alpha-fetoprotein (AFP), alpha-fetoprotein heterogeneity L3 (AFP-L3), Golgi protein 73 (GP73), vascular endothelial growth factor (VEGF) and matrix metalloproteinase (MMP) levels were detected by ELISA. Results At the end of 4 weeks after treatment, the objective response rate (ORR) in group A was 70.0%, significantly higher than 51.4% in group B or 33.3% in group C(P＜0.05); serum AFP, AFP-L3, GP73, VEGF and MMP levels in group A were (121.0±20.8)ng/mL, (5.9±0.9)ng/mL, (62.8±3.5)ng/mL, (265.3±20.4)pg/mL and (60.2±11.7)ng/L, significantly lower than [(133.0±18.1)ng/mL, (6.5±0.7)ng/mL,(71.4±3.2)ng/mL,(296.1±30.9)pg/mL and (72.5±7.3)ng/L, respectively, P＜0.05] in group B or [(143.0±15.3)ng/mL, (6.9±0.8)ng/mL,(78.3±3.7)ng/mL,(320.5±32.7)pg/mL and (85.5±15.6)ng/L, respectively, P＜0.05] in group C; the one-year cumulative survival rate in group A was 72.2%(13/18), significantlyhigher than 52.9%(18/34) in group B or 41.2%(7/17, P＜0.05) ingroup C. Conclusion The short-term efficacy of patients with PLC after 3DCRT treatmentmight be related to the GTV, and needs further clinical investigation.

Key words: Hepatoma, Three-dimensional conformal radiotherapy, Gross tumor volume, Survival

张凯, 刘培培, 饶石磊, 王琦, 岳恺, 王旸, 杨峥, 张松. 三维适形放射治疗不同大体肿瘤体积的原发性肝癌患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 710-713.

Zhang Kai, Liu Peipei, Rao Shilei, et al.. Survival rates in patients with primary liver cancer and different gross tumor volumes after radiotherapy[J]. Journal of Practical Hepatology, 2022, 25(5): 710-713.

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三维适形放射治疗不同大体肿瘤体积的原发性肝癌患者疗效研究^*

Survival rates in patients with primary liver cancer and different gross tumor volumes after radiotherapy

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