外科理念指导下的大肝癌放疗

Radiotherapy for large hepatocellular carcinoma under the guidance of surgical principle

近年来随着医疗技术水平的提高,肝癌的治疗疗效较前有所提高,但对于大肝癌的治疗仍是临床治疗难点。介绍了大肝癌的生物学特性,对大肝癌的手术治疗(包括肝切除术和肝移植术)、放射治疗的疗效进行了阐述。认为借鉴外科理念,放疗为不能手术的患者提供了一个新的选择。但如何量化肝功能储备的指标,如何限制健肝的体积及受照射剂量,联合其他局部治疗提高肿瘤控制率,仍是亟待解决的问题。

In recent years, with the development of medical technology, the treatment outcome of hepatocellular carcinoma （HCC） has im proved substantially. However, the treatment of large HCC is still a difficult clinical problem. The biological characteristics of large HCC, as well as the surgical treatments （hepatectomy and liver transplantation） and radiotherapy for large HCC, are reviewed. Under the guidance of surgical principle, radiotherapy can be considered as an alternative treatment for the inoperable patients. However, bow to quantify the indi ces of hepatic functional reserve, how to limit the volume of normal liver and its radiation dose, and how to combine radiotherapy with other local treatments to increase tumor control rate are the urgent problems to be addressed.