Clinical Study On The Treatment Of Primary Liver Cancer With The Combination Of Cyber Knife And Transcatheter Arterial Chemoembolization

Objective:Analysis and comparison of Cyber knife,transcatheter arterial chemoembolization(TACE)and Cyber knife combined TACE treatment of primary liver cancer(PHC)clinical efficacy,quality of life,tumor markers,adverse reactions,so as to provide clinical basis for the Cyber knife combined TACE treatment of primary liver cancer.Methods:A retrospective analysis of January 2014 December 2016 Ruikang Hospital of Guangxi traditional Chinese Medicine University Affiliated Tumor hospital admitted 148 cases without surgical treatment in primary hepatocellular carcinoma patients,the Cyber knife treatment group of 49 cases,TACE 52 cases in the treatment group,the Cyber knife combined with TACE group of 47 cases.Cyber knife group specific method for B-US or CT guided implantation is the gold standard,3-4 gold standard implanted liver tumor beside at about 2cm,the gold standard one week after implantation for CT positioning,target delineation,clinical target area CTV(Clinical Target Volume),the design of treatment plan using TPS2.0.5 version this,according to the specific circumstances of patients with liver cancer,such as size,quantity,distribution and so on,to determine the therapeutic dose and treatment plan,for a total dose of 40 50Gy/3 5Fiaction,using G3 Cyber knife stereotactic radiotherapy.TACE group specific method is the use of Seldinger technology after successful puncture,catheterization,after percutaneous intubation to femoral artery,and celiac artery,hepatic artery angiography confirmed by micro catheter successfully,super selective to the target vessel,the first infusion of raltitrexed plus lobaplatin,injecting embolic agents(1040ml lipiodol and gelfoam particles).After operation,the tube was pulled out,and the puncture point was compressed and bandaged.Interval 3-4 weeks the next TACE,treatment of 1-3 times.The combination of Cyber knife and TACE group was 1 to 2 times TACE,the specific method was the same as group of TACE,and then the interval was between 2 and 3 weeks,were treated with Cyber knife,the specific method was the same as group of Cyber knife.The short-term efficacy,quality of life,tumor markers and adverse reactions were compared between the three groups.Using SPSS 17.0 statistical software package for statistical analysis of data from measurement data to mean ±standard deviation((?)±S)said,between multiple groups of data comparison,using the single factor analysis of variance.The comparison between the groups,the measurement data using LSD test.Count data by chi-square(?~2)test.The median(Median)test is used for the unknown or skewed distribution of data types.Rank sum test for ordered data.Results:(1)There was no significant difference in baseline data among the three groups of patients with primary liver cancer(P > 0.05).(2)effect: three groups of patients with primary liver cancer after the clinical efficacy,ECOG physical status score,tumor markers AFP,AFU rate of decline was statistically significant difference(P < 0.05);comparison between groups,Cyber knife combined TACE patients and patients with Cyber knife group after the clinical efficacy,ECOG physical status score,tumor markers AFP,AFU rate of decline was statistically significant difference(P < 0.05),Cyber knife combined with TACE group and TACE group patients after treatment the clinical efficacy,physical status ECOG score,tumor markers AFP,AFU rate of decline the comparison was statistically significant difference(P <0.05).(3)The incidence of adverse reactions: three groups of patients with primary liver cancer after leukopenia rate was statistically significant difference(P < 0.05);comparison between groups,Cyber knife combined with radiation therapy in patients with TACE group were Cyber knife group of white blood cells after the reduction rate was statistically significant difference(P < 0.05),Cyber knife combined with TACE group and TACE group patients after the treatment of leukopenia rate was statistically significant difference(P < 0.05);adverse reactions of thrombocytopenia,liver dysfunction,gastrointestinal reaction occurred but three groups of patients with primary liver cancer after the comparison was not statistically significant the difference(P < 0.05).Cconclusions:(1)Efficacy: for the treatment of primary liver cancer patients,Cyber knife combined TACE treatment than simple Cyber knife treatment or simple TACE treatment,curative effect is better;effectively improve the patient's quality of life;it also effectively reduces the tumor markers AFP,AFU value.(2)The incidence of adverse reactions: for the treatment of primary liver cancer patients,Cyber knife combined with TACE in treatment of Cyber knife treatment than simple treatment or simple TACE operation,the decrease of white blood cells to increase the rate of adverse reactions,adverse reactions but thrombocytopenia,liver dysfunction,gastrointestinal reaction was not statistically significant difference.