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Typus
KomplettPlagiat
Bearbeiter
Hindemith
Gesichtet
Yes.png
Untersuchte Arbeit:
Seite: 12, Zeilen: 1-14
Quelle: Hawkins and Dawson 2006
Seite(n): 1654, Zeilen: r.col: 20-48
Systemic chemotherapy has had limited impact in HCC (Leung et al. 2002;Mathurin et al. 1998). Historically, radiation therapy (RT) has played a minor role in the management of patients with unresectable liver cancer, primarily because of the low tolerance of the whole liver to RT and challenges associated with delivering highly conformal, high-dose RT to liver tumors while sparing dose to the uninvolved liver. There is a below 5% risk of radiation-induced liver injury after uniform whole-liver RT of 28 to 35 Gy delivered over 3 weeks, (Emami et al. 1991;Leung et al. 2002) doses that are far less than those required to eradicate tumor. The most common liver toxicity observed in North America is radiation-induced liver disease (RILD), which is a clinical syndrome of anicteric hepatomegaly, ascites and elevated liver enzymes (particularly serum alkaline phosphatase) that occurs from 2 weeks to 3 months after external beam RT (Leung et al. 2002). Treatment for RILD consists of supportive measures and in the minority of patients, it can result in liver failure. Reactivation of viral hepatitis and precipitation of underlying liver disease also can occur after RT for HCC (Cheng et al. 2004b).

Cheng JC, Wu JK, Lee PC, Liu HS, Jian JJ, Lin YM, Sung JL, Jan GJ (2004b) Biologic susceptibility of hepatocellular carcinoma patients treated with radiotherapy to radiation-induced liver disease. Int J Radiat Oncol Biol Phys 60:1502-1509

Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21:109-122

Leung TW, Tang AM, Zee B, Yu SC, Lai PB, Lau WY, Johnson PJ (2002) Factors predicting response and survival in 149 patients with unresectable hepatocellular carcinoma treated by combination cisplatin, interferon-alpha, doxorubicin and 5-fluorouracil chemotherapy. Cancer 94:421-427

Mathurin P, Rixe O, Carbonell N, Bernard B, Cluzel P, Bellin MF, Khayat D, Opolon P, Poynard T (1998) Review article: Overview of medical treatments in unresectable hepatocellular carcinoma--an impossible meta-analysis? Aliment Pharmacol Ther 12:111-126

Systemic chemotherapy has had limited impact in

HCC.31–33 [...]

Historically, radiation therapy (RT) has played a minor role in the management of patients with unresectable liver cancer, primarily because of the low tolerance of the whole liver to RT and challenges associated with delivering highly conformal, high-dose RT to liver tumors while sparing dose to the uninvolved liver. There is a >5% risk of radiation-induced liver injury after uniform whole-liver RT of 28 gray (Gy) to 35 Gy delivered over 3 weeks,34,35 doses that are far less than those required to eradicate tumor. The most common liver toxicity observed in North America is radiation-induced liver disease (RILD), which is a clinical syndrome of anicteric hepatomegaly, ascites, and elevated liver enzymes (particularly serum alkaline phosphatase) that occurs from 2 weeks to 3 months after external beam RT.35 Treatment for RILD consists of supportive measures, and, in the minority of patients, it can result in liver failure. Reactivation of viral hepatitis and precipitation of underlying liver disease also can occur after RT for HCC.36


31. Mathurin P, Rixe O, Carbonell N, et al. Review article: overview of medical treatments in unresectable hepatocellular carcinoma—an impossible metaanalysis? Aliment Pharmacol Ther. 1998;12:111-126.

32. Burroughs A, Hochhauser D, Meyer T. Systemic treatment and liver transplantation for hepatocellular carcinoma: two ends of the therapeutic spectrum. Lancet Oncol. 2004;5:409-418.

33. Leung TW, Tang AM, Zee B, et al. Factors predicting response and survival in 149 patients with unresectable hepatocellular carcinoma treated by combination cisplatin, interferon-alpha, doxorubicin and 5-fluorouracil chemotherapy. Cancer. 2002;94:421-427.

34. Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991;21:109-122.

35. Lawrence TS, Robertson JM, Anscher MS, Jirtle RL, Ensminger WD, Fajardo LF. Hepatic toxicity resulting from cancer treatment. Int J Radiat Oncol Biol Phys. 1995;31:1237-1248.

36. Cheng JC, Wu JK, Lee PC, et al. Biologic susceptibility of hepatocellular carcinoma patients treated with radiotherapy to radiation-induced liver disease. Int J Radiat Oncol Biol Phys. 2004;60:1502-1509.

Anmerkungen

The copied text starts on the previous page: Iam/Fragment 011 30

Note that the copied material is not always correctly reproduced: ">5% risk" --> "below 5% risk".

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