γ-ray Stereotactic Radiotherapy For Primary Liver Cancer Clinical Observation

Primary liver cancer is a common malignant tumor, and its incidence has risen in recent years. Because of its hidden onset, the time of diagnosis most patients have unresectable, non-surgical treatment as the primary means of treating liver cancer. With computers and the rapid development of medical imaging, radiation technology advances, CT simulator and planning system for stereotactic radiotherapy clinical application, so that liver fractionated stereotactic radiotherapy is possible for patients with inoperable liver cancer treatment provides a new method of treatment.γ-ray stereotactic body radiotherapy system (Whole body y-knife), is a fusion of stereotactic technology, surgical technology and modern computer technology, and to treat disease, body-based stereotactic radiotherapy equipment. Whole body y-knife compared with conventional radiotherapy with high dose tumor, surrounding normal tissue with low damage and so on, more and more attention.γ-knife treatment in our hospital with 96 cases of primary liver cancer, to obtain a more satisfactory effect, these are as follows:Objective:To Investigate an effective non-surgical treatment of primary liver cancer.Methods:From September 2000 to June 2009, we adopted y-ray stereotactic radiotherapy for 96 cases of primary liver cancer patients and analyzed retrospectively the relevant data. Whole body y knife applied vacuum pad and three-dimensional coordinates of stereotactic body frame fixed position, CT scanning under simulated aircraft position; slice thickness 3-5mm, CT image through the network to the planning system. According to three-dimensional shape of lesions, size and physical condition of the patient to determine the number of targets, frequency of treatment and sub-dose, for radiation treatment planning design.40-90% isodose curve covering more than 95% target and to ensure that important organizations in the range of acceptable doses, a treatment plan is verified, transfer to the treatment system and be transferred to fractionated radiotherapy. We at the end of treatment after 3 months after the CT or MRI, according to WHO criteria for efficacy evaluation, the clinical benefit response factors by calculating the rate of clinical benefit response, according to RTOG criteria to evaluate radiation toxicity, telephone follow-up statistical survival.Results:3 months after treatment, we review CT or MRI, CR18 cases (17.7%), PR53 cases (55.2%), NC15 cases (16.7%), PD8 (10.4%), effective (CR+PR) 72.9%. Tumor size≤5cm in 18 cases, with 88.9%; tumor diameter 5-10cm in 40 cases, efficiency 77.5%; tumor diameter≥10cm in 38 cases,60.5% efficiency. Efficiency among the groups and median survival time was significantly different, suggesting that the small diameter of the tumor and the survival rate of local tumor control rates were better than the large diameter of the tumor. After treatment, pain relief was 89%(33/37); treatment KPS increased by 20 points or more 55 cases,57%(55/96); more than 7% weight gain after treatment of 59 cases,61%(59/96), overall clinical benefit response rate of 87%(84/96). In the 62 cases of AFP-positive hepatocellular carcinoma after treatment negative or titer decreased in 55 cases, accounting for 88.7%(55/62).96 cases of grade III and above the response rate of 25%(24/96).6 months survival rate was 62.5%(60/96),1-year,2-year,3-year survival rate were 61.5%(59/96),33.3%(32/96), and 14.6%(14/96).Conclusion:Gamma Knife treatment of primary liver cancer should be based on tumor size, location, liver function, general condition and other factors in patients with individualized treatment, and tumor size is different, the local control rates is different, that the smaller the tumor size, a single dose the higher, the shorter treatment time, and its efficiency and survival times is longer. Primary liver cancer with tumor thrombus is not a contraindication of y knife treatment, and y knife treatment can improve patient survival. And y knife with interventional therapy, traditional Chinese medicine combined treatment of primary liver cancer can improve the short and long term. Body y knife treatment can make primary liver cancer by high-dose radiation, reduce the surrounding normal tissue injury, and have a recent treatment significantly and a low complication rate, that is inoperable primary liver cancer patients in a safe and effective method one.