Effect Of Cyber-Knife Radiotherapy For Primary Liver Carcinoma On Liver Function

Objective: To study the effect of Cyber-knife radiotherapy for primary liver carcinoma on liver function.Methods:Between August 2009 and December 2012,104 liver cancer patients of Child-Pugh class A to B who were treated by Cyber-knife were collected. To assess the deterioration of those hepatic function, we observed biochemical indexes, blood Clotting function and Child-Pugh class before and after therapy. Using paired t test to analysis the change of live function, survival rates were estimated using the Kaplan-Meier method.Results:The response rate （CR+PR） was 80.8%, and the median survival time was 19 months. After 1 to 2 months with Cyber-knife, the Child-Pugh score increased, serologic ALB declined, serologic AST raised. All of these indexes had statistic difference（P< 0.05）. The indexes of above-mentioned improved prominently after 3 months of treated by Cyber-knife radiotherapy. Within 5 months after treatment,41 （39.4%） patients experienced an increase in Child-Pugh score,17 patients experienced progression in Child-Pugh class and 24 patients experienced liver toxicity （grade 2-3）.Conclusion:Hepatic injury caused by Cyber-knife radiotherapy was obvious in 1 to 2 months after treatment, it recovered after 3 months. This study indicated that most of primary liver carcinoma patients’ liver functions could tolerate Cyber-knife radiotherapy so long as we know well of the indication.Objective: To identify the clinical and dosimetric parameters that pre出ctthe lisk of hepatic injury for patients with primary liv carcinoma（PLG） treated with Cyber-knifeMethods:Between August 2009 and December 2012, 104 liver cancer patients of Child-Pugh A th B who were treated by Cyber-knife were collected.104 patients Kceived doses ranging 28 from 55 Gy in 2 th 6 fractions, dose pfraction is 8¹6Gy. The wlation between hepatic injury and the clinical/dosimetric parameters were analyzed. Clinical factors include gender, age,ECOG score, UICC/AJCC TNM stage, HBV status, portal vein thrombosis and Ghild-Pugh class, GTV, total do and dose par fraction. Dosimetric parameters include NLV, V₅, V₁0, V₁5, V₂0, V₂5 and V₃0. Logistic regression was used for finding independent factor of hepatic injury.Results Within 5 months after Cyber-knife therapy, 17 patients experienced progression in Child-Pugh class and 24 patients experienced liver toxicity（grade2 ³ï¼‰. Univariate analysis showed that all parameters have nothing th do with the Child-Pugh class progression. GTV, V₅、V₁0, V₁5, V₂0, V₂5 and V₃0 associated with the occurrence of liver toxicity（grade 2-3）. Multivariate analysis showed that only the V25 was independent factor of liver thxicity. The areas under theROC curves of V₂5 was 0J55（ %%CI; 0.072⁰.878） and the optimum Cå±±-off value of V₂5 was 31.5% with a sensitivity of 65.5% and specificity of 87.8%.Conclusion V₂5 was a significant parameter for grade 2³ liver t;oxicity and can serve as an effective dosimetry parameter th assess the risk of hepatic injury.