质子刀放射治疗肝细胞癌的研究进展

随着对正常组织耐受能力的研究的不断深入和放疗技术的发展，针对大部分肝细胞癌（HCC）患者伴有的肝硬化，肿瘤体积大、多发且伴有血管浸润，甚至出现门静脉癌栓等现状，放射治疗便成为HCC降级治疗及辅助治疗的重要手段。其中质子刀（PBT）作为一种较新型的放疗方法取得了较为显著的临床效果。介绍了PBT治疗HCC的生物学特性及其临床疗效和毒性副作用。前期的研究结果表明PBT对于局部照射剂量具有良好的控制作用，可降低对健康肝细胞及周围正常组织的毒性。但目前的临床研究显示PBT应用于HCC也存在着一些禁忌证，值得进一步界定。

Research advances in proton beam therapy for hepatocellular carcinoma

Hepatocellular carcinoma （HCC） , one of the most common malignancies with high prevalence and mortality rate, usually results in poor prognosis and limited survival. A comprehensive analysis on the number and location of tumors, Child - Pugh grade, and Barcelona Clinic Liver Cancer stage will help the development of suitable treatment programs and improve prediction of prognosis. A majority of patients are complicated by cirrhosis, enlarged tumor, multiple lesions, vascular invasion, and even cancer embolus in the portal vein. With the growth of knowledge about the radiation tolerance of normal tissue and the advances in radiotherapy techniques, radiotherapy has become an important tool for step - down therapy and adjuvant therapy for liver cancer. Proton beam therapy （PBT） is emerging as a novel radiotherapy for the management of HCC, which, benefiting from the effect of Bragg Peak from PBT, effeetively decreases the toxicity of traditional radio- therapies to the liver and does little harm to the uninvolved liver tissue or the surrounding structures while intensifying the destruction in tar- geted malignant lesions. Furthermore, several previous studies on the treatment of HCC with PBT revealed excellent local control. The dis-tinctive biophysical attributes of PBT in the treatment of HCC, as well as the available literature regarding clinical outcomes and toxicity of u- sing PBT for HCC, are reviewed. Current evidence provides limited indications for PBT, which suggests that further study on the relationship between liver function and PBT is required to gain further insight into its indication and standardization.