必需功能性肝体积评估在孤立性大肝癌γ-立体定向消融放射治疗中的应用研究

Research on evaluation of essential functional liver volume of solitary large hepatocellular carcinoma before γ-SABR

随着现代医疗技术的飞速进展,放射治疗在肝癌治疗中占据了重要地位。根据大肝癌的生物学特点、肝癌放射治疗的国内外现状及发展趋势、以及大肝癌立体定向放射治疗技术特征,得出了肝癌放射治疗效果可与手术切除相媲美的结论。γ-立体定向消融放射治疗(γ-SABR)为高度精确的立体定向放射治疗,目前在γ-SABR治疗前,需根据患者全身状况,肿瘤大小和肝脏功能情况做宏观评估。由于放射性肝损伤潜在风险较大,因此在实施大肝癌立体定向放射治疗前,功能性肝体积评估就显得尤为重要。为此,借鉴肝脏外科肝脏储备功能共识和肝评估决策树,将必需功能性肝体积和剩余功能性肝体积的概念应用于γ-SABR临床实践,有着重要的现实意义。

With the rapid development of medical technology, radiation therapy in the treatment of liver cancer occupies the important position. According to the biological characteristics of large liver cancer, the development of liver cancer radiotherapy at home and abroad and the technical features of stereotactic radiotherapy, it is concluded that the effect of radiation therapy of liver cancer can be comparable to those of surgery. γ-SABR is a kind of high accuracy of stereotactic radiotherapy. Before the treatment, usually do a rough evaluation according to the patient general condition, tumor size, and the liver function. The potential risk of radiation induced liver disease is very big. Therefore, the evaluation of essential functional liver volume of large liver cancer is particularly important before stereotactic radiotherapy. Draw lessons from the consensus of liver reserve function and the decision tree of liver function, the concept of essential functional liver volume and remaining functional liver volume is applied to the γ-SABR are being studied in clinical trials. This review is intend to outline the evaluation of essential functional liver volume of solitary large hepatocellular carcinoma before γ-SABR.