2009, Volume 11, Issue 10
Strategic Study of CAE >> 2009, Volume 11, Issue 10
Three-dimensional conformal and intensity modulated radiation therapy for hepatocellular carcinoma:basic study and clinical trials
Fudan University Cancer Center, Shanghai 200032, China
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Abstract
This report consists of two parts: basic study and clinical trial for 3-dimensional conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT) in treating hepatocellular carcinoma (HCC). The technique of 3DCRT and IMRT has been established for HCC irradiation. And 3 clinical trials have been carried out, which yielded encouraging outcome with 3-year rvivals of 28 % to 33 % for locally advanced HCC. Radiation induced liver disease (RILD) was the predominant complication, resulting in a mortality of 76 %. It was critical to keep irradiation dose to normal liver in a tolerable level. For HCC patients associated with hepatic cirrhosis, tolerance was mean dose to normal liver of 23 Gy for Child-Pugh A and 6 Gy for Child-Pugh B, instead of 30 Gy generally used for liver without cirrhosis in the West. A Lyman mathematic model was established,which coule predicate the RILD occurrence probability for Chinese HCC patients.The model has apparently different parameters from those abroad.The established technique of HCC irradiation,which is fit to Chinese HCC,has been successfully applied in a series of clinical trials.It demonstrates that radiation therapy is one of the treatment choices for medically inoperable and technically unresectable HCC.
Keywords
3-dimensional conformal radiation therapy ; intensity modulated radiation therapy ; epatocellular carcinoma ; liver irradiation tolerance
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References
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