Radiotherapy treatment of adrenal gland metastases from hepatocellular carcinoma: clinical features and prognostic factors

详细信息    查看全文

• 作者：Le-Yuan Zhou ; Zhao-Chong Zeng ; Jia Fan ; Bing Chen ; Sheng-xiang Rao ; Jian He…
• 关键词：Hepatocellular carcinoma ; Adrenal gland ; Metastasis ; Radiotherapy ; Prognosis
• 刊名：BMC Cancer
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：361 KB
• 参考文献：1. Shuto, T, Hirohashi, K, Kubo, S, Tanaka, H, Tsukamoto, T, Yamamoto, T, Ikebe, T, Kinoshita, H (1998) Changes and results of surgical strategies for hepatocellular carcinoma: results of a 15-year study on 452 consecutive patients. Surg Today 28: pp. 1124-1129 CrossRef
  2. Zeng, ZC, Tang, ZY, Fan, J, Zhou, J, Qin, LX, Ye, SL, Sun, HC, Wang, BL, Yu, Y, Wang, JH, Guo, W (2004) A comparison of chemoembolization combination with and without radiotherapy for unresectable hepatocellular carcinoma. Cancer J 10: pp. 307-316 CrossRef
  3. Zimmerman, MA, Ghobrial, RM, Tong, MJ, Hiatt, JR, Cameron, AM, Hong, J, Busuttil, RW (2008) Recurrence of hepatocellular carcinoma following liver transplantation: a review of preoperative and postoperative prognostic indicators. Arch Surg 143: pp. 182-188 CrossRef
  4. Katyal, S, Oliver, JH, Peterson, MS, Ferris, JV, Carr, BS, Baron, RL (2000) Extrahepatic metastases of hepatocellular carcinoma. Radiology 216: pp. 698-703 CrossRef
  5. Momoi, H, Shimahara, Y, Terajima, H, Iimuro, Y, Yamamoto, N, Yamamoto, Y, Ikai, I, Yamaoka, Y (2002) Management of adrenal metastasis from hepatocellular carcinoma. Surg Today 32: pp. 1035-1041 CrossRef
  6. Park, JS, Yoon, DS, Kim, KS, Choi, JS, Lee, WJ, Chi, HS, Kim, BR (2007) What is the best treatment modality for adrenal metastasis from hepatocellular carcinoma?. J Surg Onco 96: pp. 32-36 CrossRef
  7. Zeng, ZC, Tang, ZY, Fan, J, Zhou, J, Qin, LX, Ye, SL, Sun, HC, Wang, BL, Zhang, JY, Yu, Y, Cheng, JM, Wang, XL, Guo, W (2005) Radiation therapy for adrenal gland metastases from hepatocellular carcinoma. Jpn J Clin Oncol 35: pp. 61-67 CrossRef
  The diagnostic criteria and stages of primary hepatoma in the 4th National Conference of Liver Cancer: Problems and Discussion. Chin J Gen Surg 15: pp. 238-239
  8. Therasse, P, Arbuck, SG, Eisenhauer, EA, Wanders, J, Kaplan, RS, Rubinstein, L, Verweij, J, Glabbeke, MV, Oosterom, AT, Christian, MC, Gwyther, SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92: pp. 205-216 CrossRef
  9. Zeng, ZC, Tang, ZY, Fan, J, Qin, LX, Ye, SL, Zhou, J, Sun, HC, Wang, BL, Wang, JH (2005) Consideration of role of radiotherapy for lymph node metastases in patients with HCC: retrospective analysis for prognostic factors from 125 patients. Int J Radiat Oncol Biol Phys 63: pp. 1067-1076 CrossRef
  10. Williamson, A, Hoggart, B (2005) Pain: a review of three commonly used pain rating scales. J Clin Nurs 14: pp. 798-804 CrossRef
  DCTDN, NIH, NHHS.
  11. Cheng, JC, Chou, CH, Kuo, ML, Hsieh, CY (2006) Radiation-enhanced hepatocellular carcinoma cell invasion with MMP-9 expression through PI3K/Akt/NF-kappaB signal transduction pathway. Oncogene 25: pp. 7009-7018 CrossRef
  12. Chou, CH, Teng, CM, Tzen, KY, Chang, YC, Chen, JH, Cheng, JC (2012) MMP-9 from sublethally irradiated tumor promotes Lewis lung carcinoma cell invasiveness and pulmonary metastasis. Oncogene 31: pp. 458-468 CrossRef
  13. Yuen, MF, Hou, JL, Anuchit, C (2009) Hepatocellular carcinoma in the Asia pacific region. J Gastroenterol Hepatol 24: pp. 346-353 CrossRef
  14. He, J, Zeng, ZC, Tang, ZY, Fan, J, Zhou, J, Zeng, MS, Wang, JH, Sun, J, Chen, B, Yang, P, Pan, BS (2009)
• 刊物主题：Cancer Research; Oncology; Stem Cells; Animal Models; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2407

文摘

Background The optimal treatment for adrenal metastases from hepatocellular carcinoma (HCC) has not been established. This study analyzed the effects of radiation therapy (RT) for such metastases and identified clinical features and predictors of survival in these patients. Methods We retrospectively investigated 55 patients with adrenal metastasis from HCC who had been treated with RT. Radiation doses to the adrenal lesions ranged from 26 to 60?Gy, while the intrahepatic lesions were treated by surgical resection, transarterial chemoembolization (TACE), liver transplantation, and/or RT. RT was conducted to adrenal lesions after their intrahepatic lesions were controlled more than 2?months. The parameters studied included survival rates and tumor responses to RT. The Kaplan-Meier method was used to evaluate survival rate and the Cox regression model was used to identify potential predictors of outcome. Results The patients treated by RT had adrenal metastasis on the right side (41), the left (6), or on both sides (8). In all 55 patients, the median survival duration was 13.6?months and there was 100% pain relief after completion of RT. Adverse effects were mild to moderate. Unfavorable pretreatment predictors determined by univariate analysis were associated with multiple intrahepatic foci, metastases to additional organs, high γ-glutamyltransferase and alpha-fetoprotein levels, liver function of Child-Pugh classification B and uncontrolled primary HCC. By multivariate analysis, unfavorable predictors were multiple intrahepatic foci, metastases to additional organs and uncontrolled primary HCC. Conclusions Radiotherapy as treatment for adrenal metastases in HCC is a good palliative therapy that is associated with reasonable safety. It appears reasonable that such patients should be considered to be treated with radiotherapy. Multiple intrahepatic foci, metastases to additional organs and uncontrolled primary HCC were unfavorable predictors.