文章：

碳离子放射治疗（CIRT）治疗肝细胞癌后的不良事件及CIRT后胆道狭窄风险因素：一项回顾性研究

Adverse Events After Carbon-Ion Radiotherapy (CIRT) for Hepatocellular Carcinoma and Risk Factors for Biliary Stricture After CIRT: A Retrospective Study

原文发布日期：31 July 2025

DOI: 10.3390/cancers17152542

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: This study investigated the timing of adverse events (AEs) after carbon-ion radiotherapy (CIRT) for hepatocellular carcinoma (HCC) and identified the risk factors for biliary stricture post CIRT.Methods: This retrospective study included 103 patients with HCC who had undergone CIRT (60 Gy/4 fractions). The onset, frequency, and grade of AEs after CIRT were analyzed. HCC was classified into perihilar and distal types to assess the frequency of biliary stricture, and the risk factors for biliary stricture were investigated.Results: AEs after CIRT were more frequent in patients with liver dysfunction, skin redness/dermatitis, and pigmentation. Biliary stricture occurred long after CIRT (3.0–17.0 months). Most AEs were of grade 1–2. Grade ≥ 3 AEs included biliary stricture (2.9%) and radiation gastric ulcer (1.0%), whereas grade 5 AEs included biliary stricture (1.9%). Biliary stricture was exclusively observed in patients with perihilar-type HCC. Among patients with perihilar-type HCC, those having a tumor in the portal vein trunk branch area were more prone to biliary stricture than those with a tumor in the primary portal vein branch area (p= 0.0018), and all grade ≥ 3 biliary strictures (2.9%) were observed in the portal vein trunk branch area. Patients with perihilar-type HCC and biliary stricture were more likely to have macrovascular invasion (p= 0.0052) and previous local therapy targeting the perihilar region (p= 0.0371) than those without biliary stricture.Conclusions: This study reported the detailed data of AEs post CIRT for HCC and the risk factors for biliary stricture post CIRT.

摘要翻译： 

背景/目的：本研究旨在探讨肝细胞癌（HCC）患者接受碳离子放疗（CIRT）后不良事件（AEs）的发生时间，并明确CIRT后胆道狭窄的危险因素。方法：这项回顾性研究纳入了103例接受CIRT（60 Gy/4次分割）的HCC患者。分析了CIRT后AEs的发生时间、频率及分级。将HCC分为肝门部型和远端型以评估胆道狭窄的发生率，并探究胆道狭窄的危险因素。结果：肝功能不全、皮肤红斑/皮炎及色素沉着患者在CIRT后更易发生AEs。胆道狭窄多发生于CIRT后较长时间（3.0–17.0个月）。大多数AEs为1–2级。≥3级AEs包括胆道狭窄（2.9%）和放射性胃溃疡（1.0%），而5级AEs包括胆道狭窄（1.9%）。胆道狭窄仅见于肝门部型HCC患者。在肝门部型HCC患者中，肿瘤位于门静脉主干分支区域者比位于门静脉一级分支区域者更易发生胆道狭窄（p=0.0018），且所有≥3级胆道狭窄（2.9%）均出现在门静脉主干分支区域。与无胆道狭窄的肝门部型HCC患者相比，合并胆道狭窄者更常伴有大血管侵犯（p=0.0052）及既往针对肝门区域的局部治疗史（p=0.0371）。结论：本研究报告了HCC患者CIRT后AEs的详细数据及CIRT后胆道狭窄的危险因素。

原文链接：

Adverse Events After Carbon-Ion Radiotherapy (CIRT) for Hepatocellular Carcinoma and Risk Factors for Biliary Stricture After CIRT: A Retrospective Study