原发性肝癌不同放射治疗技术的选择和临床应用

Radiotherapy techniques for hepatocellular carcinoma

放射治疗技术在近20年来已取得很大发展。从三维适形放射治疗开始,放射治疗越来越多地被用于原发性肝细胞肝癌(hepatocellular carcinoma,HCC)的治疗。目前,HCC的治疗包括一系列先进的技术,如调强放射治疗(intensity-modulated radiotherapy,IMRT),体部立体定向放射治疗(stereotactic body radiotherapy,SBRT),粒子治疗(charged particle therapy)等。IMRT能够实现在肿瘤体积较大或临近重要器官时,提高肿瘤受照剂量的同时降低正常组织受量。SBRT能够给予小肝癌高剂量单次或者多次精确照射,获得极佳的局部控制率。本文综述肝癌现代放射治疗技术的研究进展。

Radiotherapy techniques have improvedin the last two decades. After the introduction of 3-dimensional conformal radiotherapy, radiotherapy has been increasingly used for the treatment of hepatocellular carcinoma(HCC).Currently, moreadvanced techniques, including intensity-modulated radiotherapy(IMRT), stereotactic body radiotherapy(SBRT), and charged particle therapy, are increasingly used for the treatment of HCC. It has beenpossible for IMRT to deliver a higher dose of radiation to part of the liver accurately without a signifcant dose increase in the other adjacent critical structures. SBRT can deliver a very high radiation dose to small HCCs in a few fractions, leading to high local control rates.This review aims tosummarize modern advances in radiotherapyin the treatment of primary hepatocellular carcinoma.