Curative Effect And Safety Analysis Of Gamma Knife Treatment For Primary Liver Cancer

OBJECTIVE: To observe the short-term efficacy,long-term outcome and side effects of radiotherapy in the treatment of primary hepatocellular carcinoma.Methods: Retrospective analysis of clinical data from 53 patients with primary hepatocellular carcinoma treated in our hospital from January 2013 to December 2015,including 41 males and 12 females;17 cases younger than 60 years old,36 cases of ECOG PS score of 0 points,16 cases of 1 point,10 cases of 2 points,8 cases of the largest diameter less than 5cm,31 cases of 5-10 cm,14 cases of more than 10 cm,1 case of 21 cases,more than 2 cases of 32 cases;accompanied by portal vein tumor thrombus in 7 cases,with inferior vena cava tumor thrombus in 3 cases;AFP greater than 400?g / ml in 37 cases,less than 400?g / ml in 16 cases;Thirty-six patients underwent TACE surgery,22 had not received TACE surgery,35 had Child-Pugh liver function rating,18 had ChildPugh liver function rating B,18 had clinical stage 1,21 cases of stage ?,20 cases of stage ?,the use of China's Shenzhen Owo company independent research and development production OUR-QGD type body gamma knife treatment,treatment plan requires 50% of the dose line covered 100% PTV,70% dose line Covering 90% of GTV,a single dose of 3 ~ 5Gy,1 times / day,5 times / week,a total of 10 ~ 17 times,the total dose of 40 ~ 52 Gy treatment.The adverse effects of radiotherapy were evaluated by RTOG acute grading standard.RECIST criteria were used to evaluate the short-term curative effect,and SPSS 20.0 statistical software was used for data processing.P <0.05 for the difference was statistically significant.Results: After treatment with gamma knife,the first curative effect was improved in 5 cases(9.4%),partial remission(PR)in 16 cases(30.2%),stable disease(SD)(ORR)was 39.6%(21/53),disease control rate(DCR)was 75.5%(40/53),serum(P <0.05)(AFP)level,compared with the treatment of AFP levels decreased significantly,and there was significant difference(P <0.01).6 months,12 months,18 months survival rates were 52.8%,43.4%,28.3%.Gastrointestinal reactions were nausea,decreased appetite,vomiting,diarrhea,etc.,the vast majority of which showed ? degree(12 cases,26.4%),? degree(2 cases,3.8%),? degree(1 case,1.9% Relatively small,symptomatic treatment: metoclopramide,ranitidine,domperidone,etc.,drink plenty of water and add a lot of vitamins,relieve patient concerns,enhance the patient's disease and fight the confidence,after the symptoms improved;liver function for transaminase l(12.4%)patients with white blood cells and other decreased,given the recombinant human granulocyte stimulating factor after the rise.Conclusion: This study shows that body gamma knife is safe and effective in the treatment of primary liver cancer,the treatment of mild adverse reactions,for the treatment of primary liver cancer to obtain a better effect.