抗病毒药物预防肝细胞癌放疗后HBV再激活

StephenW

Virginia Schad, PharmD
August 20, 2018
Antivirals Prevent HBV Reactivation After Radiotherapy for Hepatocellular Carcinoma

Preventive therapy against HBV reactivation is recommended for patients with hepatocellular carcinoma who are scheduled to receive radiotherapy. Preventive therapy against HBV reactivation is recommended for patients with hepatocellular carcinoma who are scheduled to receive radiotherapy.

Preventive therapy against hepatitis B virus (HBV) reactivation is recommended for patients with hepatocellular carcinoma (HCC) who are scheduled to receive radiotherapy (RT), according to a retrospective, multicenter study published in PLoS One.1

HBV reactivation can occur in patients with chronic hepatitis B, which can lead to premature termination of chemotherapy or can delay treatment schedules in patients with cancer receiving chemotherapy.2,3 The risk for HBV reactivation after RT in patients with HCC remains unclear; therefore, researchers in South Korea evaluated the medical records of 133 people with HCC who were positive for hepatitis B surface antigen and who received RT from March 2009 to February 2016.1

Of the total, 27 patients did not receive antiviral therapy before RT and 106 patients underwent antiviral therapy before RT. Overall, HBV reactivation occurred in 17 (12.7%) patients after RT. Those in the antiviral group had significantly lower rates of HBV reactivation than those in the non-antiviral group (7.5% vs 33.3%, respectively; P <.001).

The mean duration of HBV reactivation after RT was 2.3 months. The development of HBV-related hepatitis was also lower in the antiviral group compared with the non-antiviral group (3.8% vs 14.8%, P =.031), which suggests that antiviral treatment can prevent hepatitis after RT. Major risk factors for HBV reactivation during RT are combined treatment of RT with transarterial chemoembolization and non-antiviral treatment.


“In conclusion, HBV reactivation that causes hepatitis can occur after RT in [people with] HCC,” stated the authors.1 In addition, “Antiviral therapy can reduce HBV reactivation and complications after RT. Therefore, preventive antiviral therapy should be recommended for patients with HCC who are scheduled to receive RT.”
References

    Jun BG, Kim YD, Kim SG, et al. Hepatitis B virus reactivation after radiotherapy for hepatocellular carcinoma and efficacy of antiviral treatment: a multicenter study. PLoS One. 2018;13(7):e0201316.

StephenW

Virginia Schad，PharmD
2018年8月20日
抗病毒药物预防肝细胞癌放疗后HBV再激活

对于计划接受放射治疗的肝细胞癌患者，建议采取预防性治疗，以防止HBV再激活。对于计划接受放射治疗的肝细胞癌患者，建议采取预防性治疗，以防止HBV再激活。

根据PLoS One.1发表的一项回顾性多中心研究，建议对计划接受放疗（RT）的肝细胞癌（HCC）患者进行乙型肝炎病毒（HBV）再激活的预防性治疗。

HBV再激活可能发生在慢性乙型肝炎患者身上，这可能导致化疗过早终止或延迟接受化疗的癌症患者的治疗时间表.2,3肝癌患者接受RT后HBV再激活的风险仍不明确;因此，韩国研究人员评估了133名HCC患者的医疗记录，这些患者乙型肝炎表面抗原阳性，并于2009年3月至2016年2月接受了RT。

在总数中，27名患者在接受RT治疗前未接受抗病毒治疗，106名患者在接受RT治疗前接受了抗病毒治疗。总体而言，RT后17例（12.7％）患者发生HBV再激活。抗病毒组的HBV再激活率显着低于非抗病毒组（分别为7.5％和33.3％，P <.001）。

RT后HBV再激活的平均持续时间为2.3个月。与非抗病毒组相比，抗病毒组HBV相关性肝炎的发展也较低（3.8％对14.8％，P = .031），这表明抗病毒治疗可以预防RT后的肝炎。 RT期间HBV再激活的主要危险因素是RT与经动脉化学栓塞和非抗病毒治疗的联合治疗。


作为结论，在[HCC患者]放疗后，HBV再激活可引起肝炎。“作者说。”此外，“抗病毒治疗可以减少转归后HBV的再激活和并发症。因此，对于预定接受转运的HCC患者，应推荐预防性抗病毒治疗。
参考

    Jun BG，Kim YD，Kim SG，et al。肝细胞癌放疗后乙型肝炎病毒再激活和抗病毒治疗的疗效：一项多中心研究。 PLoS One。 2018; 13（7）：e0201316。