肝细胞肝癌肾上腺转移的放射治疗

目的探讨肝癌肾上腺转移的放射治疗效果.方法回顾性总结本院22例肝癌肾上腺转移病人,用6MX或15MV光子,进行肾上腺病灶外照射,剂量36～54Gy,中位剂量50Gy.结果14例肾上腺转移病人出现疼痛症状,外放疗后11例(78.6%)疼痛得到完全缓解;2例(14.3%)得到明显缓解,但仍需要止痛药治疗;73%(15/22)病例的肿瘤明显缩小;全部病例中位生存期为10个月;未出现因肾上腺转移灶致死病例;副作用轻微.结论肝细胞肝癌肾上腺转移对放射治疗敏感,50Gy的放疗剂量是比较安全的姑息性治疗.

Radiation therapy for adrenal gland metastases from hepatocellular carcinoma

Objective The adrenal gland is a common site of extrahepatic metastases from hepatocellular carcinoma.However,it has been the subject of few studies,and the optimal treatment remains unclear.The managements for adrenal gland metastasis of hepatocellular carcinoma have been tried with surgical resection,transarterial chemoembolization,or percutaneous ethanol injection on the basis of case reports.External beam radiation therapy is seldom application to the patients with adrenal gland metastases.Methods We retrospectively studied 22 patients with adrenal metastases from hepatocellular carcinoma treated with limited-field external beam radiation therapy.The radiation dose to adrenal lesion ranged from 36 to 54(median 50)Gy,while the intrahepatic lesions were treated with either surgical resection or transarterial chemoembolization.Results Of 14 patients had pain related to adrenal metastases,11(78.6%)patients had complete pain relief without medication that lasted until death.Two(14.3%)patients had marked pain relief,but still required analgesics.Partial responses on tumor were observed in 73%.The median survival period for all patients was 10 months.No patient died from adrenal metastasis-related complications.Adverse effects were mild.Conclusion Adrenal metastases from hepatocellular carcinoma are sensitive to radiation treatment.Radiation therapy with 50 Gy for adrenal gland metastases is a good palliative therapy and safety.