2012年10月28-31日，第54届美国放射肿瘤学会（ASTRO）年会在美国波士顿举行。来自世界各地的放射肿瘤学领域的医生及相关人士共计11000多人参会。本届年会的主题是“通过创新改善患者治疗（Advancing Patient Care through Innovation）”。金宝搏网站登录技巧 对本届年会进行了专题报道（http://zt.cmt.com.cn/zt/astro2012/index.html），敬请关注！

　　会上，加拿大学者报告了一项研究：Phase II Trial of Palliative Radiation Therapy for Symptomatic Hepatocellular Carcinoma and Liver Metastases，其摘要如下：

Purpose/Objective(s)
This study was designed to evaluate the effectiveness of palliative liver radiation therapy (RT) in improving symptoms and quality of life (QOL) from symptomatic liver cancer.

Materials/Methods
Eligible patients had unresectable hepatocellular carcinoma (HCC) or liver metastases (LM) not suitable for standard therapies, with an index symptom of pain, abdominal discomfort, nausea, or fatigue attributable to hepatic tumor burden. Blood work requirements included: hemoglobin >70, platelets >25,000, INR <3, bilirubin <100, AST or ALT <10X normal, and Child-Pugh score A or B. RT consisted of a single 8-Gy fraction to encompass all symptomatic liver cancer (often whole liver). Patients were premedicated with dexamethasone and ondansetron. A modified Brief Pain Inventory (BPI) was completed at baseline, 1 week, 1, 3, and 6 months follow-ups to assess the index symptom response. The primary outcome was a clinically significant change in BPI at 1 month from baseline of ≥2 points on a 0-10 scale. The secondary objectives were a clinically significant change in QOL assessed through the FACT-Hep, and EORTC QLQ-C30 questionnaires. Patients were stratified between HCC and LM.

Results
Forty eligible patients (29 male, 11 female) with end-stage HCC (21) or LM (19) with a median age of 65 years (range 40-84) were accrued to the study. The baseline ECOG performance status was 0 or 1 in 63% of patients. The baseline Child-Pugh was A and B in 78% and 22%, respectively. The median survival for all patients was 4.4 months (95% confidence interval [CI] 2.7-5.4 months). The primary index symptom for patients was pain or abdominal discomfort in 35, nausea in 3, and fatigue in 2 patients. The percent of patients with a clinically significant change in their index symptom from baseline to 1 month in the modified BPI scales of symptom at its worst, at its least, at its average in the past week, and now, was 48% (HCC 50%, LM 45%), 40% (HCC 50%, LM 27%), 52% (HCC 50%, LM 55%), and 32% (HCC 43%, LM 18%), respectively. At 1 month, in 35 patients with pain or discomfort at baseline, a clinically significant improvement in overall abdominal discomfort or pain intensity was seen in 35% and 30%, respectively. Clinically significant improvements in the FACT-G and the hepatobiliary subscales of the FACT-Hep were seen in 44% and 30% of HCC and LM patients, respectively. There were also improvements in patients' functional (e.g., 63% of patients had an improvement in physical function) and symptom components (e.g., 37% of patients had an improvement in pain) of the EORTC QLQ-C30 questionnaire. There were no serious adverse events related to treatment.

Conclusions
Clinically meaningful improvements in patient symptoms and quality of life were observed at 1 month in over one-third of patients with symptomatic HCC and LM. Palliative radiation therapy appears to benefit symptomatic liver cancer patients and it should be investigated in a phase III study.