국소 진행된 간암의 방사선 온열치료성적

• 영문명: The Clinical Results of Thermo-Irradiation on the Locally Advanced Hepatoma with or without Hepatic Arterial Chemo-Embolization
• 발행기관: 대한방사선종양학회
• 저자명: 장홍석(Hong Seok Jang) 윤세철(Sei Chul Yoon) 강기문(Ki Mun Kang) 유미령(Mi Ryeong Ryu) 김성환(Sung Hwan Kim) 백남종(Nam Jong Baek) 윤승규(Seung Kyoo Yoon) 김부성(Boo Sung Kim) 신경섭(Kyung Sbu Shinn)
• 간행물 정보: 『대한방사선종양학회지』제12권 제1호, 81~90쪽, 전체 10쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 1994.02.28

영문 초록

Purpose : The aim of this study is to analyze the clinical results of thermo-irradiation treatment for surgically unreserctable advanced hepatoma with or without hepatic arterial chemo-embolization (HACE), chemotherapy (CT) and interferon (IFN) therapy. Materials and Methods : Between February 1990 and December 1992. 45 patients with surgically unresectable advanced hepatomas were treated by thermo-irradiation with or without hepatic arterial chemo-embolization and other treatment modalities. Among them, We analyzed retrospectively 24 patients who received more than three times of hyperthermias. Mean age was 50 years (range : 18-71 years) and male to female ratio was 20:5. In the study, treatment was administered as follows : 3patients received radiation therapy(RT) and hyperthermia (HT). 3 received RT+HT+CT. 3received RT+HT+HACE. 1received RT+HT+CT+HACE. 2 received RT+HT+CT+IFN. 10 received RT+HT+HACE+IFN. 3 received RT+HT+CT+HACE+IFN. Radiation therapy was done by a 6 MV linear accelerator. Patients were treated with daily fractions of 180 cGy to doses of 11gy-50Gy (median 30Gy). Local hyperthermia was done by HEH-500C(Omron Co.Japan), 30-45 min/session, 2 sessions/wk and the number of HT sessions ranged from 3 to 17 (median 7 times). 15 patients of 25 were followed by abdominal CT scan or abdominal ultra-sonogram. The following factors were analyzed : Age, histologic grade, sex, number of hyperthermia, total RT dose, hepatic arterial chemo-embolization. Results : Of 25 patients, there were observed tumor regression (partial response and minimal response) in 6(24%), no response in 8(32%), progression in 1(4%) and not evaluable ones in 10(40%) radiographically. The over all 1-year survival was 25%, with a mean survival of 33 weeks. The treatment modes of partial and minimal responsive patients (PR+MR) were as follow : Two were treated with RT+HT+HACE 2 were done with RT+HT+HACE+IFN Remaining 2 were treated with RT+HT+CT+HACE+IFN. The significant factor affecting the survival rate were RT dose (more than 25 Gy), HACE, number of HT(above 6 times), responsiveness after treatment (PR+MR). Age, sex, histologic differentiation, chemotherapy, interferon therapy were not statistically significant factors affecting the survival rate. Conclusion : Although follow-up duration was short, the thermo-irradiation with/without hepatic arterial chemo-embolization was well tolerated and there were no serious complications. In future, it is considered the longer follow up and prospective, well controlled trials should be followed to evaluate the efficacies of survival advantage.

키워드

Hepatoma Hyperthermia Radiotherapy Hepatic arterial chemo-embolization This paper was supported by 1994 CUMC Clinical Medical Research Fund and Catholic Cancer Center Fund