The Values Of CT In Evaluation Of Primary Liver Cancer Before And After Proton Therapy

Objective：This study is the comparison of patients’ quality of life,short-term efficacy,survivalrate,efficiency and side effects before and after proton beam therapy of primary livercancer with CT, Evaluating the value of the proton beam therapy in the treatment ofprimary liver cancer.Materials and Methods：44patients were collected from August2006to December2011at the Zibo Wan JieTumor Hospital, everyone suffered from primary liver cancer confirmed by pathology,imaging, inspection, and all of patients received proton therapy. Proton planning systemdesigned treatment programs, with1to3radiation field,100%of planning target volume(PTV) was included to90%-95%isodose curve. The number of tumor irradiation was10-32times,3-6times per week,2-6Gy each time, total dose was50to78Gy. CT scanswere performed before and after proton radiotherapy, statistical comparison of lesion size,CT value, enhanced features and the surrounding liver tissue changes. Quality of life ofpatients after proton therapy, the short-term efficacy, survival rate, efficiency, side effectswere summarized.Results：Follow-up to December2011, the follow-up period is3to36months and follow-uprate is100%. The quality of life of patients (symptoms, signs) were significantly improvedafter proton therapy, patients with upper abdominal pain, bloating, fatigue and otherperformance after proton therapy,the improvement rate was80%(25/31); Ascites inpatients with proton therapy, the improvement rate is66.7%(2/3); the improvement rate ofskin jaundice is75%(3/4). The efficiency rate and survival rate results after proton therapy:the review of Proton therapy after three months, the total efficiency rate (CR+PR) was72.7%(32/44),2-year survival rate was56.8%(25/44). Observations after Proton therapyCT scan (lesion size, density and enhanced features): by the summary of the patients with CT imaging data, the lesion sizes, CT values of primary liver cancer after protonradiotherapy were generally smaller than the one before proton radiotherapy, after analyzedstatistically (P <0.05), there was significant statistical difference between the twogroups(P<0.05), to prove that CT images can accurately reflect the efficacy of thetreatment of cancer proton knife. Observations of adverse reactions after proton therapy:during treatment there were six cases with varying degrees of weakness, loss of appetiteand other symptoms, including one case with low-grade fever (<38.5degrees), four casesof grade II acute skin reactions, one case of leukopenia in the treatment, one case ofanemia cases, one case of patient with massive liver cancer with grade I liver adversereactions, two cases of patients with grade II acute upper gastrointestinal reaction after6months, and improved after treatment.Conclusion：Proton therapy for liver cancer is an effective, safe method with smaller sideeffects.the CT scan accurately reflect the effect from lesion size, density, enhanced featuresand the surrounding liver tissue changes after proton radiotherapy, and can provide areliable basis for clinical treatment plan, so it is one of the important means evaluating theefficacy of primary liver cancer after proton radiotherapy.