文章：

使用Vero4DRT万向架直线加速器立体定向放射治疗（SBRT）系统对肝细胞癌进行动态肿瘤追踪（DTT）

Dynamic Tumor Tracking (DTT) for Hepatocellular Carcinoma Using the Vero4DRT Gimbaled Linac Stereotactic Body Radiation Therapy (SBRT) System

原文发布日期：6 September 2025

DOI: 10.3390/cancers17172926

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: Stereotactic body radiation therapy (SBRT) is a therapeutic option for hepatocellular carcinoma (HCC). This study reviewed outcomes and toxicities of SBRT for HCC using a gimbal-mounted linear accelerator and real-time monitoring system.Methods: A single-institution, retrospective review of SBRT for HCC using DTT between January 2018 and December 2020 was undertaken. Endpoints included local control (LC) and overall survival (OS).Results: A total of 74 patients with 82 tumors treated were identified. Median follow-up was 40.8 months. LC at 1, 3, and 5 years was 89.6%, 71.0%, and 59.9%, respectively. Median time to local failure was not reached. Median OS was 41.3 months (95% CI 30.7–51.8 months). OS at 1, 3, and 5 years was 89.2%, 60.6%, and 33.9%, respectively. On UVA, GTV ≥ 30 cm3(p= 0.038), and PTV ≥ 150 cm3(p= 0.010) were associated with an absolute drop in platelet count by ≥50,000/mm3within six weeks of SBRT, while prior focal liver treatment (p= 0.097) showed a trend toward significance. Underlying viral cirrhosis (p= 0.033), A6 or higher pre-SBRT Child–Pugh score (p= 0.010), and pre-SBRT platelet count <100,000/mm3(p= 0.017) were significant for a rise in Child–Pugh score of 2 points or more, and the volume of liver-GTV <1000 cm3(p= 0.093) approached significance.Conclusions: SBRT using DTT is an effective therapeutic option for selected patients with HCC, providing acceptable local control and toxicity.

摘要翻译： 

背景/目的：立体定向体部放射治疗（SBRT）是肝细胞癌（HCC）的一种治疗选择。本研究回顾了使用万向节安装直线加速器和实时监测系统对HCC进行SBRT的疗效与毒性。 方法：对2018年1月至2020年12月期间使用DTT技术进行SBRT治疗的HCC患者进行了单机构回顾性分析。评估终点包括局部控制率（LC）和总生存期（OS）。 结果：共纳入74例患者，治疗了82个肿瘤。中位随访时间为40.8个月。1年、3年和5年的LC分别为89.6%、71.0%和59.9%。未达到中位局部失败时间。中位OS为41.3个月（95% CI 30.7–51.8个月）。1年、3年和5年的OS分别为89.2%、60.6%和33.9%。单变量分析显示，肿瘤靶区体积（GTV）≥30 cm³（p=0.038）和计划靶区体积（PTV）≥150 cm³（p=0.010）与SBRT后六周内血小板计数绝对下降≥50,000/mm³相关，而既往局部肝脏治疗（p=0.097）显示出接近显著性的趋势。基础病毒性肝硬化（p=0.033）、SBRT前Child-Pugh评分A6或更高（p=0.010）以及SBRT前血小板计数<100,000/mm³（p=0.017）与Child-Pugh评分上升2分或以上显著相关，而肝脏-GTV体积<1000 cm³（p=0.093）接近显著性。 结论：对于经过选择的HCC患者，使用DTT技术的SBRT是一种有效的治疗选择，能提供可接受的局部控制率和毒性。

原文链接：

Dynamic Tumor Tracking (DTT) for Hepatocellular Carcinoma Using the Vero4DRT Gimbaled Linac Stereotactic Body Radiation Therapy (SBRT) System