Role of stereotactic body radiation therapy for hepatocellular carcinoma
Abstract
โรคมะเร็งเซลล์ตับเป็นโรคที่พบได้บ่อยในประเทศไทย ผู้ป่วยส่วนมากมักมาพบแพทย์เมื่อมีอาการมากเกินกว่าที่จะรับการ รักษาแบบหวังผลหายขาดได้ ในอดีตทางเลือกที่ยังพอทำได้ในผู้ป่วยกลุ่มนี้คือการทำ Transarterial chemoembolization หรือให้ targeted therapy แต่เนื่องจากในปัจจุบัน เทคนิคการฉายรังสีมีความก้าวหน้าขึ้นอย่างมาก จึงทำให้การฉายรังสีเข้า มามีบทบาทมากขึ้นเรื่อยๆ ในการรักษาผู้ป่วยมะเร็งเซลล์ตับ
References
รายงานประจำปี 2558 กรมควบคุมโรค. 2558:86.
Sriraj P, Boonmars T, Aukkanimart R, Songsri J, Sripan P, Ratanasuwan P, et al. A combination of liver fluke infection and traditional northeastern Thai foods associated with cholangiocarcinoma development. Parasitol Res. 2016; 115:3843-52.
Mirrorer M. Liu SHC, Andrew T. Huang. Cancer of Liver and Hepatobiliary Tract. In: Edward C. Halperin, David E. Wazer, Carlos A. Perez, Luther W. Brady, editors. Perez and Brady's principles and practice of radiation oncology. 6th ed. Philadelphia: LIPPINCOTT WILLIAMS & WILKINS; 2013. p. 1215-31.
Pelloni A, Gertsch P. [Risks and consequences of tumor seeding after percutaneous fine needle biopsy four diagnosis of hepatocellular carcinoma]. Schweiz Med Wochenschr. 2000; 130:871-7.
Torzilli G, Minagawa M, Takayama T, Inoue K, Hui AM, Kubota K, et al. Accurate preoperative evaluation of liver mass lesions without fine-needle biopsy. Hepatology. 1999; 30:889-93.
Lok AS, Sterling RK, Everhart JE, Wright EC, Hoefs JC, Di Bisceglie AM, et al. Des-gamma-carboxy prothrombin and alpha-fetoprotein as biomarkers for the early detection of hepatocellular carcinoma. Gastroenterology. 2010; 138:493-502.
Trevisani F, D'Intino PE, Morselli-Labate AM, Mazzella G, Accogli E, Caraceni P, et al. Serum alphafetoprotein for diagnosis of hepatocellular carcinoma in patients with chronic liver disease: influence of HBsAg and anti-HCV status. J Hepatol. 2001; 34:570-5.
European Association for Study of L, European Organisation for R, Treatment of C. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Eur J Cancer. 2012; 48:599-641.
Korean Liver Cancer Study G, National Cancer Center K. 2014 Korean Liver Cancer Study Group-National Cancer Center Korea practice guideline for the management of hepatocellular carcinoma. Korean J Radiol. 2015; 16:465-522.
Bruix J, Sherman M, American Association for the Study of Liver D. Management of hepatocellular carcinoma: an update. Hepatology. 2011; 53:1020-2.
Omata M, Lesmana LA, Tateishi R, Chen PJ, Lin SM, Yoshida H, et al. Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma. Hepatol Int. 2010; 4:439-74.
Korean Liver Cancer Study G, National Cancer Center K. [Practice guidelines for management of hepatocellular carcinoma 2009]. Korean J Hepatol. 2009; 15:391-423.
Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973; 60:646-9.
Blei AT, Cordoba J, Practice Parameters Committee of the American College of G. Hepatic Encephalopathy. Am J Gastroenterol. 2001; 96:1968-76.
Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000; 31:864-71.
Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003; 124:91-6.
Forner A, Reig ME, de Lope CR, Bruix J. Current strategy for staging and treatment: the BCLC update and future prospects. Semin Liver Dis. 2010; 30:61-74.
Cheng E.Y., Zarrinpar A, Geller D.A., Goss J.A., Busuttil R.W. Liver. New York: McGraw-Hill Education/Medical; 2014 [cited 2016 Dec 19]. Available from: http://accessmedicine.mhmedical.com/content.as px?bookid=980&Sectionid=59610873.
Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996; 334:693-9.
Yao FY, Ferrell L, Bass NM, Watson JJ, Bacchetti P, Venook A, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology. 2001; 33:1394-403.
Patel SS, Arrington AK, McKenzie S, Mailey B, Ding M, Lee W, et al. Milan Criteria and UCSF Criteria: A Preliminary Comparative Study of Liver Transplantation Outcomes in the United States. Int J Hepatol. 2012; 2012:253517.
การรักษาผู้ป่วยมะเร็งตับโดยการจี้ด้วยคลื่นความถี่วิทยุ (Radio Frequency Ablation). 2009 [cited 2016 Sep 19]; Available from: http://www.si.mahidol.ac.th/th/department/radiology/diagRadiology/rfa.html.
Yang W, Yan K, Goldberg SN, Ahmed M, Lee JC, Wu W, et al. Ten-year survival of hepatocellular carcinoma patients undergoing radiofrequency ablation as a first-line treatment. World J Gastroenterol. 2016; 22:2993-3005.
Sucandy I, Cheek S, Golas BJ, Tsung A, Geller DA, Marsh JW. Longterm survival outcomes of patients undergoing treatment with radiofrequency ablation for hepatocellular carcinoma and metastatic colorectal cancer liver tumors. HPB (Oxford). 2016; 18:756-63.
Liu PH, Lee YH, Hsu CY, Huang YH, Chiou YY, Lin HC, et al. Survival advantage of radiofrequency ablation over transarterial chemoembolization for patients with hepatocellular carcinoma and good performance status within the Milan criteria. Ann Surg Oncol. 2014; 21:3835-43.
Kim JW, Kim JH, Won HJ, Shin YM, Yoon HK, Sung KB, et al. Hepatocellular carcinomas 2-3 cm in diameter: transarterial chemoembolization plus radiofrequency ablation vs. radiofrequency ablation alone. Eur J Radiol. 2012; 81:e189-93.
Hsu CY, Huang YH, Chiou YY, Su CW, Lin HC, Lee RC, et al. Comparison of radiofrequency ablation and transarterial chemoembolization for hepatocellular carcinoma within the Milan criteria: a propensity score analysis. Liver Transpl. 2011; 17:556-66.
Yang B, Zan RY, Wang SY, Li XL, Wei ML, Guo WH, et al. Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials. World J Surg Oncol. 2015; 13:96.
Lo CM, Ngan H, Tso WK, Liu CL, Lam CM, Poon RT, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology. 2002; 35:1164-71.
Llovet JM, Real MI, Montana X, Planas R, Coll S, Aponte J, et al. Arterial embolisation or chemoembolization versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomized controlled trial. Lancet. 2002; 359:1734-9.
Zhang Y, Li Y, Ji H, Zhao X, Lu H. Transarterial Y90 radioembolization versus chemoembolization for patients with hepatocellular carcinoma: A meta-analysis. Biosci Trends. 2015; 9:289-98.
Lewandowski RJ, Kulik LM, Riaz A, Senthilnathan S, Mulcahy MF, Ryu RK, et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant. 2009; 9:1920-8.
Carr BI, Kondragunta V, Buch SC, Branch RA. Therapeutic equivalence in survival for hepatic arterial chemoembolization and yttrium 90 microsphere treatments in unresectable hepatocellular carcinoma: a two-cohort study. Cancer. 2010; 116:1305-14.
Kooby DA, Egnatashvili V, Srinivasan S, Chamsuddin A, Delman KA, Kauh J, et al. Comparison of yttrium-90 radioembolization and transcatheter arterial chemoembolization for the treatment of unresectable hepatocellular carcinoma. J Vasc Interv Radiol. 2010; 21:224-30.
Adnane L, Trail PA, Taylor I, Wilhelm SM. Sorafenib (BAY 43-9006, Nexavar), a dual-action inhibitor that targets RAF/MEK/ERK pathway in tumor cells and tyrosine kinases VEGFR/PDGFR in tumor vasculature. Methods Enzymol. 2006; 407:597-612.
Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008; 359:378-90.
Hennequin C, Quero L, Rivera S. [Radiosensitivity of hepatocellular carcinoma]. Cancer Radiother. 2011; 15:39-42.
Brian D. Kavanagh, Jeffrey D. Bradley, Robert D. Timmerman. Stereotactic Irradiation of Tumors Outside the Central Nervous System. In: Edward C. Halperin, David E. Wazer, Carlos A. Perez, Luther W. Brady, editors. Perez and Brady's principles and practice of radiation oncology. 6th ed. Philadelphia: LIPPINCOTT WILLIAMS & WILKINS; 2013. p. 362-70.
Blomgren H, Lax I, Naslund I, Svanstrom R. Stereotactic high dose fraction radiation therapy of extracranial tumors using an accelerator. Clinical experience of the first thirty-one patients. Acta Oncol. 1995; 34:861-70.
Cardenes HR, Price TR, Perkins SM, Maluccio M, Kwo P, Breen TE, et al. Phase I feasibility trial of stereotactic body radiation therapy for primary hepatocellular carcinoma. Clin Transl Oncol. 2010; 12:218-25.
Culleton S, Jiang H, Haddad CR, Kim J, Brierley J, Brade A, et al. Outcomes following definitive stereotactic body radiotherapy for patients with Child-Pugh B or C hepatocellular carcinoma. Radiother Oncol. 2014; 111:412-7.
Kang J, Nie Q, Du R, Zhang L, Zhang J, Li Q, et al. Stereotactic body radiotherapy combined with transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombosis. Mol Clin Oncol. 2014; 2:43-50.
Kang JK, Kim MS, Cho CK, Yang KM, Yoo HJ, Kim JH, et al. Stereotactic body radiation therapy for inoperable hepatocellular carcinoma as a local salvage treatment after incomplete transarterial chemoembolization. Cancer. 2012; 118:5424-31.
Tsai CL, Hsu FM, Cheng JC. How to Improve Therapeutic Ratio in Radiotherapy of HCC. Liver Cancer. 2016; 5:210-20.
Radiologists TRAaNZCo. Guidelines for Safe Practice of Stereotactic Body (Ablative) Radiation Therapy. Sydney2015 [cited 2016 Dec 19]; Available from: http://www.ranzcr.edu.au/resources/professionaldocuments/guidelines.
Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, et al. Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys. 2010; 37:4078-101.
Immobilization and Imaging for Stereotactic Body Radiation Therapy Motion Management. 2015 [cited 2016 Dec 19]; Available from: http://therss.org/docs/5ceb073a-aa0f-45e7-a232-a241e13a2359.pdf.
Solberg TD, Medin PM, Mullins J, Li S. Quality assurance of immobilization and target localization systems for frameless stereotactic cranial and extracranial hypofractionated radiotherapy. Int J Radiat Oncol Biol Phys. 2008; 71:S131-5.
Fletcher JG. Adjusting kV to Reduce Dose or Improve Image Quality - How to Do it Right. 2010 [cited 2016 Dec 19]; Available from: https://www.aapm.org/meetings/2010CTS/documents/1130Fletcher-AutokV-04-29-2010.pdf.
Respiratory Motion Management for CT. 2013 [cited 2016 Dec 19]; Available from: http://healthmanagement. org/uploads/Respiratory%20Motion%20Management%20for%20CT_white%20paper.pdf.
Keall PJ, Mageras GS, Balter JM, Emery RS, Forster KM, Jiang SB, et al. The management of respiratory motion in radiation oncology report of AAPM Task Group 76. Med Phys. 2006; 33:3874-900.
Dawson LA. Randomized Phase III Study of Sorafenib versus Stereotactic Body Radiation Therapy followed by Sorafenib in Hepatocellular Carcinoma. [updated February 23, 2016] [cited 2016 Dec 19]; Available from: https://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails.aspx?study=1112.
Tipton KN, Sullivan N, Bruening W, Inamdar R, Launders J, Uhl S, et al. Stereotactic Body Radiation Therapy [Internet]; 2011 [cited 2016 Dec 19]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK55723/pdf/Bookshelf_NBK55723.pdf.
Stereotactic body radiotherapy (SBRT). [updated February 29, 2016] [cited 2016 Dec 19]; Available from: http://www.cancerresearchuk.org/about-cancer/cancers-in-general/treatment/radiotherapy/external/stereotactic-body-radiotherapy-sabr.
National Radiotherapy Implementation Group Report Stereotactic Body Radiotherapy Guidelines for Commissioners, Providers and Clinicians in England 2011. 2011 [cited 2016 Dec 19]; Available from: http://www.cancerresearchuk.org/cancer-info/prod_consump/groups/cr_common/@nre/@new/@gen/documents/generalcontent/cr_074729.pdf.
Klein EE, Hanley J, Bayouth J, Yin FF, Simon W, Dresser S, et al. Task Group 142 report: quality assurance of medical accelerators. Med Phys. 2009; 36:4197-212.
Chae SM, Lee GW, Son SH. The effect of multileaf collimator leaf width on the radiosurgery planning for spine lesion treatment in terms of the modulated techniques and target complexity. Radiat Oncol. 2014; 9:72.
Wu QJ, Wang Z, Kirkpatrick JP, Chang Z, Meyer JJ, Lu M, et al. Impact of collimator leaf width and treatment technique on stereotactic radiosurgery and radiotherapy plans for intra- and extracranial lesions. Radiat Oncol. 2009; 4:3.
Ye J-S, Wu J, Chen F, Hill G, Spiegel J, Mehta V. Impact of Leaf Width on Treatment Plan Quality in Stereotactic Body Radiation Therapy of Lung Cancers. The SRS/SBRT Scientific Meeting 2014. 2014 [cited 2016 Dec 19]; p. 56. Available from: http://therss.org/document/docdownload.aspx?docid=1538
Protocol of Radiotherapy for Hepatocellular Carcinoma. [cited 2016 Dec 19]. Available from; https://www.chimei.org.tw/main/cmh_department/55700/RT_guideline/08%20HCC.pdf.
Ding C, Solberg TD, Hrycushko B, Xing L, Heinzerling J, Timmerman RD. Optimization of normalized prescription isodose selection for stereotactic body radiation therapy: conventional vs robotic linac. Med Phys. 2013; 40:051705.
Sanuki N, Takeda A, Kunieda E. Role of stereotactic body radiation therapy for hepatocellular carcinoma. World J Gastroenterol. 2014; 20:3100-11.
Dawson LA, Hashem S, Bujold A. Stereotactic body radiation therapy for hepatocellular carcinoma. Am Soc Clin Oncol Educ Book. 2012:261-4.
Kwon JH, Bae SH, Kim JY, Choi BO, Jang HS, Jang JW, et al. Long-term effect of stereotactic body radiation therapy for primary hepatocellular carcinoma ineligible for local ablation therapy or surgical resection. Stereotactic radiotherapy for liver cancer. BMC Cancer. 2010; 10:475.
Seo YS, Kim MS, Yoo SY, Cho CK, Choi CW, Kim JH, et al. Preliminary result of stereotactic body radiotherapy as a local salvage treatment for inoperable hepatocellular carcinoma. J Surg Oncol. 2010; 102:209-14.
Huang WY, Jen YM, Lee MS, Chang LP, Chen CM, Ko KH, et al. Stereotactic body radiation therapy in recurrent hepatocellular carcinoma. Int J Radiat Oncol Biol Phys. 2012; 84:355-61.
Bae SH, Kim MS, Cho CK, Kim KB, Lee DH, Han CJ, et al. Feasibility and efficacy of stereotactic ablative radiotherapy for Barcelona Clinic Liver Cancer-C stage hepatocellular carcinoma. J Korean Med Sci. 2013; 28:213-9.
Jean-Emmanuel Bibault SD, Claire Vautravers-Dewas, Antoine Hollebecque, Hajer Jarraya, Thomas Lacornerie, Eric Lartigau, Xavier Mirabel. Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma: Prognostic Factors of Local Control, Overall Survival, and Toxicity. PLoS ONE. 2013; 8:e77472.
Hong L. SBRT Treatment Planning: Practical Considerations. New York; [cited 2016 Dec 19]. Available from: http://amos3.aapm.org/abstracts/pdf/68-19774-234349-85603.pdf.
Bissonnette JP, Balter PA, Dong L, Langen KM, Lovelock DM, Miften M, et al. Quality assurance for image-guided radiation therapy utilizing CT-based technologies: a report of the AAPM TG-179. Med Phys. 2012; 39:1946-63.
The Role of In-Room kV X-Ray Imaging for Patient Setup and Target Localization, Report of AAPM Task Group 104. American Association of Physicists in Medicine; 2009 [cited 2016 Dec 19]; Available from: https://www.aapm.org/pubs/reports/RPT_104.pdf.
Choi BO, Jang HS, Kang KM, Lee SW, Kang YN, Chai GY, et al. Fractionated stereotactic radiotherapy in patients with primary hepatocellular carcinoma. Jpn J Clin Oncol. 2006; 36:154-8.
Mendez Romero A, Wunderink W, Hussain SM, De Pooter JA, Heijmen BJ, Nowak PC, et al. Stereotactic body radiation therapy for primary and metastatic liver tumors: A single institution phase i-ii study. Acta Oncol. 2006; 45:831-7.
Choi BO, Choi IB, Jang HS, Kang YN, Jang JS, Bae SH, et al. Stereotactic body radiation therapy with or without transarterial chemoembolization for patients with primary hepatocellular carcinoma: preliminary analysis. BMC Cancer. 2008; 8:351.
Tse RV, Hawkins M, Lockwood G, Kim JJ, Cummings B, Knox J, et al. Phase I study of individualized stereotactic body radiotherapy for hepatocellular carcinoma and intrahepatic cholangiocarcinoma. J Clin Oncol. 2008; 26:657-64.
Louis C, Dewas S, Mirabel X, Lacornerie T, Adenis A, Bonodeau F, et al. Stereotactic radiotherapy of hepatocellular carcinoma: preliminary results. Technol Cancer Res Treat. 2010; 9:479-87.
Andolino DL, Johnson CS, Maluccio M, Kwo P, Tector AJ, Zook J, et al. Stereotactic body radiotherapy for primary hepatocellular carcinoma. Int J Radiat Oncol Biol Phys. 2011; 81:e447-53.
Chan LC, Chiu SK, Chan SL. Stereotactic radiotherapy for hepatocellular carcinoma: report of a local single-centre experience. Hong Kong Med J. 2011; 17:112-8.
Dewas S, Mirabel X, Kramar A, Jarraya H, Lacornerie T, Dewas-Vautravers C, et al. [Stereotactic body radiation therapy for liver primary and metastases: the Lille experience]. Cancer Radiother. 2012; 16:58-69.
Facciuto ME, Singh MK, Rochon C, Sharma J, Gimenez C, Katta U, et al. Stereotactic body radiation therapy in hepatocellular carcinoma and cirrhosis: evaluation of radiological and pathological response. J Surg Oncol. 2012; 105:692-8.
Ibarra RA, Rojas D, Snyder L, Yao M, Fabien J, Milano M, et al. Multicenter results of stereotactic body radiotherapy (SBRT) for non-resectable primary liver tumors. Acta Oncol. 2012; 51:575-83.
Bujold A, Massey CA, Kim JJ, Brierley J, Cho C, Wong RK, et al. Sequential phase I and II trials of stereotactic body radiotherapy for locally advanced hepatocellular carcinoma. J Clin Oncol. 2013; 31:1631-9.
Reed GB, Jr., Cox AJ, Jr. The human liver after radiation injury. A form of veno-occlusive disease. Am J Pathol. 1966; 48:597-611.
Lightdale CJ, Wasser J, Coleman M, Brower M, Tefft M, Pasmantier M. Anticoagulation and high dose liver radiation: a preliminary report. Cancer. 1979; 43:174-81.
Bearman SI, Lee JL, Baron AE, McDonald GB. Treatment of hepatic venocclusive disease with recombinant human tissue plasminogen activator and heparin in 42 marrow transplant patients. Blood. 1997; 89:1501-6.
Qi WX, Fu S, Zhang Q, Guo XM. Charged particle therapy versus photon therapy for patients with hepatocellular carcinoma: a systematic review and meta-analysis. Radiother Oncol. 2015; 114:289-95.
Honda Y, Kimura T, Aikata H, Kobayashi T, Fukuhara T, Masaki K, et al. Stereotactic body radiation therapy combined with transcatheter arterial chemoembolization for small hepatocellular carcinoma. J Gastroenterol Hepatol. 2013; 28:530-6.
Jacob R, Turley F, Redden DT, Saddekni S, Aal AK, Keene K, et al. Adjuvant stereotactic body radiotherapy following transarterial chemoembolization in patients with non-resectable hepatocellular carcinoma tumours of >/= 3 cm. HPB (Oxford). 2015; 17:140-9.
Su TS, Lu HZ, Cheng T, Zhou Y, Huang Y, Gao YC, et al. Long-term survival analysis in combined transarterial embolization and stereotactic body radiation therapy versus stereotactic body radiation monotherapy for unresectable hepatocellular carcinoma >5 cm. BMC Cancer. 2016; 16:834.
Huo YR, Eslick GD. Transcatheter Arterial Chemoembolization Plus Radiotherapy Compared With Chemoembolization Alone for Hepatocellular Carcinoma: A Systematic Review and Meta-analysis. JAMA Oncol. 2015; 1:756-65.
Ohtsubo K, Watanabe H, Tsuchiyama T, Mouri H, Yamaguchi Y, Motoo Y, et al. Advanced hepatocellular carcinoma treated effectively with irinotecan via hepatic arterial infusion followed by proton beam therapy. J Infect Chemother. 2009; 15:316-21.
Kim BK, Ahn SH, Seong JS, Park JY, Kim do Y, Kim JK, et al. Early alpha-fetoprotein response as a predictor for clinical outcome after localized concurrent chemoradiotherapy for advanced hepatocellular carcinoma. Liver Int. 2011; 31:369-76.
Ben-Josef E, Normolle D, Ensminger WD, Walker S, Tatro D, Ten Haken RK, et al. Phase II trial of highdose conformal radiation therapy with concurrent hepatic artery floxuridine for unresectable intrahepatic malignancies. J Clin Oncol. 2005; 23:8739-47.
McIntosh A, Hagspiel KD, Al-Osaimi AM, Northup P, Caldwell S, Berg C, et al. Accelerated treatment using intensity-modulated radiation therapy plus concurrent capecitabine for unresectable hepatocellular carcinoma. Cancer. 2009; 115:5117-25.
Chi KH, Liao CS, Chang CC, Ko HL, Tsang YW, Yang KC, et al. Angiogenic blockade and radiotherapy in hepatocellular carcinoma. Int J Radiat Oncol Biol Phys. 2010; 78:188-93.
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บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารมะเร็งวิวัฒน์
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับ และบุคคลากรท่านอื่น ๆ ใน สมาคมฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใดๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว