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过去的几十年,在肝转移癌的治疗方面,放疗已经越来越多的应用于临床。对于局部肝转移癌,临床上往往采取加大剂量已提高局部控制率,以期提高患者生产期。但是,对于有症状的广泛性肝转移患者则给以全肝低剂量照射。放疗已成为不适合手术或化疗等方式的肝转移癌患者的有效治疗手段。放疗靶区勾画及放疗技术进步更好的保护了高剂量靶区周围的正常肝脏组织,使得提高靶区放疗剂量的手段很好的应用于临床。关于肝转移癌的适形与立体定向放疗治疗的提高局控率及生存期的临床研究不断出现。本文就局部肝转移的根治放疗与全肝的姑息放疗临床数据做相关综述,认为放疗在肝转移癌的治疗中是安全,有效的。但是,肝转移癌的临床随机试验研究仍较匮乏。
In the past few decades, in the treatment of liver metastases, radiotherapy has been more and more used in clinical. For local liver metastases, clinically tend to increase the dose has been to increase the local control rate, in order to improve the patient’s production period. However, low-dose whole-liver irradiation is given to patients with symptomatic and extensive liver metastases. Radiotherapy has become an effective treatment for patients with liver metastases who are not suitable for surgery or chemotherapy. Radiotherapy target contouring and radiotherapy technology to better protect the high-dose target area around the normal liver tissue, making the target area to improve the dose of radiotherapy means a good application in clinical. Clinical studies on conformal and stereotactic radiotherapy for the treatment of metastatic liver cancer to improve the rate of control and the survival period continue to emerge. This article summarizes the clinical data of radical radiotherapy for local liver metastases and palliative radiotherapy of the whole liver, and concludes that radiotherapy is safe and effective in the treatment of liver metastases. However, the randomized clinical trial of liver metastases is still scarce.