2016年原发性肝癌放疗共识

随着技术进步,放疗对原发性肝癌的有效性和安全性都在不断提高,但国内至今仍无相关共识。因此,肝癌放疗的相关协会,包括中华医学会放射肿瘤学分会、中国生物医学工程学会精确放疗分会肝癌学组与消化系统肿瘤专家委员会、中国研究型医院学会放射肿瘤学分会肝癌学组共同讨论,最终形成原发性肝癌放疗共识。主要内容包括:对早中期肝癌患者,如不能进行手术切除或射频消融可考虑局部放疗,特别是SBRT;对中晚期肝癌患者,放疗可以和TACE或肝动脉灌注化疗或全身药物治疗联合,以提高治疗效果;对于晚期伴有远处转移的肝癌患者,放疗可以作为姑息减征手段,提高患者生活质量,延长生存期。虽然放疗是肝癌有效治疗手段之一,但仍需前瞻、随机、对照的Ⅲ期研究,以获得更高级别的临床证据,进一步确立放疗在肝癌治疗中的地位。

Consensus on radiation therapy for primary liver cancer in 2016

With recent advances in techniques, the efficacy and safety of radiation therapy ( RT) for primary liver cancer has been improved. However, there has been no relevant consensus in China until now. Therefore, the consensus on RT for primary liver cancer is finally reached after discussion among the following groups:Chinese Society of Radiation Oncology, Chinese Medical Association;Liver Cancer Study Group and Expert Committee on Digestive System Neoplasms, Precise Radiotherapy Branch, Chinese Society of Biomedical Engineering;Liver Cancer Study Group, Radiation Oncology Branch, Chinese Research Hospital Association. The consensus is as follows:in early or intermediate stage, if surgical resection or radiofrequency ablation is not feasible, RT, especially stereotactic body radiation therapy, can be considered;in locally advanced stage, RT combined with transarterial chemoembolization, hepatic arterial infusion chemotherapy, or systemic therapies can be considered;in advanced stage with distant metastasis, RT can be considered for palliation of symptoms caused by the primary tumor or its metastases to improve the quality of life and prolong survival. Despite the currently reported benefits of RT in primary live cancer, there is still a compelling need for prospective, randomized, controlled phase Ⅲ trials to acquire high level of clinical evidence for confirming the role of RT in the treatment of liver cancer.