Therapeutic effect and prognostic analysis of intensity-modulated radiotherapy for primary hepatocellular carcinoma with portal vein and / or inferior vena cava tumor thrombus
Objective To determine the efficacy and prognostic factors of intensity- modulated radiotherapy( IMRT) for primary hepatocellular carcinoma( HCC) with portal vein and / or inferior vena cava tumor thrombus. Methods Twenty- three HCC patients with portal vein and / or inferior vena cava tumor thrombus received IMRT with an 8 MV linear accelerator at the Cancer Center of General Hospital of Armed Police Forces,Anhui Medical University,from April 2008 to August 2011. A single dose of 3 to 6 Gy was delivered at five fractions per week,with a total dose of 56 to 96 Gy and a median dose of 60 Gy. Survival time was recorded,and adverse reactions were evaluated. Survival rate calculation and survival analysis were performed using the Kaplan- Meier method. Comparison of categorical between two groups was made by chi- square test. Results One patient did not complete radiotherapy due to upper gastrointestinal bleeding. Of 22 patients who completed IMRT,4 achieved complete remission and 10 achieved partial remission,with an overall response rate of 63. 7%. Our analysis showed that the type of tumor thrombus and tumor size were associated with tumor response rate and were significant prognostic factors( P< 0. 05). The median survival time was 13. 4 months. The 1-,2-,and 3- year survival rates were 59%,27%,and 18%,respectively. The 22 patients who completed radiotherapy did not experience acute radiation injury or late adverse outcomes such as radiation- induced liver disease. Conclusion This study suggests IMRT is a safe and effective treatment option for HCC patients with portal vein and / or inferior vena cava tumor thrombus.
检验项目参考区间是临床疾病诊断与健康监测的主要依据,参考区间的准确性、适用性直接影响着临床判断。2012年,我国卫生行业标准发布了血清AST、ALT、GGT、ALP等项目的参考区间,同时指出该参考区间可能受民族、地区影响而致其不适用,各实验室可自行建立参考区间[1]。目前建立参考区间的方法有直接法[2]和间接法[3],直接法需通过建立严格的排除标准而筛选符合要求的参考个体,且此法过程漫长繁琐、难以实施;而间接法只需通过数学统计,凭借快速简便、能得到与直接法相似结果的优势脱颖而出。本研究利用临床实验室信息系统(laboratory information system,LIS)已有数据,用数学统计模型建立AST、ALT、GGT、ALP间接法参考区间,并与国家行业标准比较,以期为临床疾病诊断与健康监测提供依据和参考。
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WANG YT, LI XW, XING DY, et al. Establishment of the reference intervals of four biochemical parameters for liver function among adults in Changchun, China based on the indirect method[J]. J Clin Hepatol, 2021, 37(9): 2161-2166. DOI: 10.3969/j.issn.1001-5256.2021.09.030.
WANG YT, LI XW, XING DY, et al. Establishment of the reference intervals of four biochemical parameters for liver function among adults in Changchun, China based on the indirect method[J]. J Clin Hepatol, 2021, 37(9): 2161-2166. DOI: 10.3969/j.issn.1001-5256.2021.09.030.