演題抄録

臓器別シンポジウム

開催概要
開催回
第55回・2017年・横浜
 

肝癌に対する放射線治療の現状・将来

演題番号 : OSY16-5

[筆頭演者]
櫻井 英幸:1 
[共同演者]
奥村 敏之:1、石川 仁:1、福光 延吉:1、大西 かよ子:1、水本 斉志:1、室伏 景子:1、沼尻 晴子:1

1:筑波大学・放射線腫瘍学

 

Radiation therapy (RT) using conventional fractionation has not been thought to be curative enough for hepatocellular carcinoma (HCC) and it has not been performed as a high priority in comparison to other standard treatments, such as surgery, percutaneous ablation and transcatheter approach. Because the liver is high sensitive to radiation, especially for patients with liver cirrhosis, non-irradiated normal liver volume must be preserved as much as possible when curative radiation is given for HCC. In recent years, since many technological progress has been made in radiation oncology, RTs are used as an important curative treatment option for liver cancer. Stereotactic body radiotherapy (SBRT) is a technique to accurately concentrate doses three-dimensionally on the target with short-term irradiation of 1-2 weeks. This technique can be used for relatively small tumors less than 5 cm with about 90% local control. Particle beam therapy (proton beam therapy, heavy ion beam therapy) has unique character of radiation dose distribution, which is called Bragg peak. PBT can accumulate more dose to the target with minimizing normal liver dose. Primary liver tumor is an important indication that has been specified to be of the highest priority by the American Society for Radiology and Oncology (ASTRO). The local control rate was approximately 90% and the 5-year survival rate was reported to be approximately 50%. Clinical studies of PBT report favorable therapeutic effects, even for not only large tumors but also tumors in elderly patient. In addition, PBT has been clearly shown to play an important role in the treatment of HCC-related portal vein tumor thrombosis (PVTT). PBT may become an option for curative local treatment of HCC, but no specific role for PBT has been described in the Japanese treatment guidelines. In this presentation, we would like to discuss the optimum choice of new RTs for several condition of the liver tumors.

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