中枢性肝細胞癌
大船中央病院放射線治療センター 武田篤也
For hepatocellular carcinomas located in hepatic hilum, radiofrequency ablation therapy may induce
hemorrhagic complication, and broad resection is often needed. Therefore, those standard therapy are often out
of indications even though hepatocellular carcinoma is small. For patients with such lesions, stereotactic body
radiotherapy is expected to be an alternative therapy. Although a concern exists that fibrotic changes after
stereotactic body radiotherapy may cause clinically severe hepatobiliary complication in the future, current
evidences show that biliary complications following stereotactic body radiotherapy were minimal.
Stereotactic body radiotherapy provides excellent local control and may be a valuable option for the treatment of
hepatocellular carcinomas located in hepatic hilum.
肝門部肝細胞癌に対する穿刺治療は誤穿刺のリスクがあり、切除では広範切除が必要となる。そのため体幹部定位放射線治療に対する期待は大き
い。体幹部定位放射線治療後に広範な線維化を起こすことが報告されている一方で、肝門部肝細胞癌に対する体幹部定位放射線治療は、今後慎重な
経過観察が必要であるが、現状において比較的安全に行えている。
