|
Primary liver cancer is one of the common malignant tumor, there is an upward trend in recent years, its incidence, its incidence of occult diagnosed, most patients have unresectable non-surgical treatment become the primary means for the treatment of liver cancer. With the rapid development of computer and medical imaging technology, advances in radiotherapy techniques, CT simulator and clinical applications of stereotactic radiation treatment planning system, the liver cancer fractionated stereotactic radiotherapy it possible to provide treatment for inoperable liver cancer patients A new treatment methods. Stereotactic body the Ya-ray body radiation therapy system (whole-body gamma knife), a fusion of stereotactic technology, surgical techniques and modern computer technology in one to treat the body malignancies based stereotactic radiotherapy equipment, general Gamma Knife compared with conventional radiotherapy with high doses of radiation oncology and surrounding normal tissue injury, more and more attention. Hospital with my whole body gamma knife treatment of 96 cases of primary liver cancer, and achieved more satisfactory results, are as follows: Objective: To investigate the primary liver cancer of non-surgical treatment effective method. : Our hospital from September 2000 to June 2009, using the whole body gamma knife treatment of 96 patients with primary liver cancer patients were analyzed retrospectively. Body Gamma Knife stereotactic body frame application of vacuum pad and the three-dimensional coordinates fixed position, the CT simulator under scanning positioning, thickness 3-5mm CT image through the network to the planning system. According to the three-dimensional shape of the lesion, the size and the physical condition of the patient to determine the target number, the number of treatments and fractionated dose radiotherapy planning design. 40-90% isodose coverage to more than 95% of the target area and to ensure that the important organizations in the range of acceptable radiation dose, treatment planning, and transferred to the treatment system after verification and fractionated radiotherapy. 3 months after the end of treatment, CT scan or MRI, and press the WHO standard for efficacy evaluation the reaction relevant factors clinical benefit response rate according to clinical benefit, with reference to the the RTOG criteria evaluation radiotherapy toxicity, telephone follow-up, statistical survival time. Results: 3 months after repeat CT or MRI, CR18 cases (17.7%), PR53 cases (55.2%), NC15 patients (16.7%), PD8 patients (10.4%), the response rate (CR PR) 72.9%. Tumor diameter ≤ 5cm in 18 cases, 88.9%; tumor diameter of 5-10cm in 40 patients, 77.5% efficiency; tumor diameter ≥ 10cm in 38 cases, 60.5% efficiency. Efficiency and the median survival time in each group, there are significant differences, suggest that tumor diameter smaller local tumor control rate and survival rate in tumor diameter greater. Pain relief after treatment was 89% (33/37); KPS increased by more than 20 points 55 cases, 57% (55/96); 59 cases of weight gain more than 7%, 61% (59/96), clinical benefit The overall response rate was 87% (84/96). 62 cases of liver cancer AFP positive seroconversion or titer decreased after treatment in 55 cases, accounting for 88.7% (55/62). 96 patients appear the grade Ⅲ response rate of 25% (24/96). 6-month survival rate was 62.5% (60/96), 1-year, 2-year, 3-year survival rate was respectively 61.5% (59/96), 33.3% (32/96), 14.6% (14/96 ). Conclusion: Whole body gamma knife treatment of primary liver cancer treatment should be individualized based on tumor size, location, Pugh, patients generally state factors; tumor size, local control rate, the smaller the tumor diameter, single The higher the dose, the shorter the duration of treatment, the better its efficacy; contraindications associated with tumor thrombus in primary liver cancer is not a whole body gamma knife treatment, and may improve the survival of patients; whole body gamma knife and interventional treatment of traditional Chinese medicine combination therapy can improve the short-term effect of primary liver cancer; whole body gamma knife treatment of primary liver cancer make tumors to high doses of radiation, reducing the damage to surrounding normal tissue, the recent significant treatment effect, low complication rate can not surgery safety of patients with primary liver cancer, one of the effective methods.
|