| Methods:A retrospective study was performed on 84 patients with liver metastasis of colorectal cancer admitted from January 2011 to December 2014.The cases were randomly divided into two groups:the control group(n=42)and the observation group(n=42).The control group was treated with chemotherapy combined with or without targeted therapy,while the observation group was treated with gamma knife on the basis of the control group.The curative effect of these two groups were evaluated according to CR,PR,PD and SD after treatment.The levels of carcinoembryonic antigen(CEA)were measured by radioimmunoassay before and 3 months after the treatment.The levels of MACC1 and interstitial-epithelial transformation factor(c-met)were respectively measured by ELISA method.CD3+,CD4+,CD8+and CD4+/CD8+ were detected before and after treatment by flow cytometry.Patients were followed up for 3 years after treatment.The sxurvival rate and time of the two groups were recorded.Patients in the observation group were labeled into CR+PR+SD group and PD group according to the therapeutic effect criteria.Univariate and multivariate Logistic analysis were applied in these factors:the gender,age,tumor size,differentiation degree,lymph node metastasis,whether they had received chemotherapy,whether they had received targeted therapy,etc.Results:(1)The efficacy rate of observation group in the following 3 months after gamma knife treatment was 88.10%,higher than that of control group,which is 64.28%(P<0.05).(2)The 1-year and 2-year survival rates in the observation group were higher than those in the control group(P<0.05),and the difference between two groups in 3-year survival rate was not obvious(P>0.05).It shows no significant difference in the mean survival time between the observation group(32.79±1.64 months)and the control group(27.66±1.91 months)(P=0.207).(3)Abdominal distension,nausea,vomiting,leukocyte decline and abnormal platelet after treatment both happened in these two groups(P>0.05).The incidence of radioactive liver disease in the observation group was higher than that in the control group(P<0.05).(4)There was no statistically significant difference in CEA,MACC1 and c-met before treatment between these two groups(P>0.05).CEA,MACC1 and c-met levels in the observation group were lower than those in the control group 3 months after treatment(P<0.05).(5)There was no significant difference in the levels of CD3+,CD4+and CD4+/CD8+before treatment between the two groups(P>0.05).CD3+,CD4+ and CD4+/CD8+levels were higher in the observation group than in the control group 3 months after treatment(P<0.05).CD8+ level was lower in the observation group than that in the control group 3 months after treatment(P<0.05).(6)All patients in the observation group successfully completed the gamma knife treatment,including 37 patients in the CR+PR+SD group and 5 patients in the PD group.Results of univariate and multivariate Logistie analysis indicated that:There was no statistically signifieant in the effect of gamma knife between those patients who took targeted therapy or not(P>0.05).The efficacy rate of gamma knife in patients with liver metastasis of colorectal cancer is related to age,tumor size,differentiation degree,lymph node metastasis CEA,MACC1 and c-met levels(P<0.05).Conclusion:The use of gamma knife in patients of colorectal cancer with liver metastasis can obtain higher short-term curative effects.It also can improve the survival rate,prolong the survival time,reduce tumor load levels,and less the side-effect in immunity.However,there are plenty of factors influencing the curative effect.Eeffective intervention should be set up to improve the therapeutic effect and the prognosis of patients. |
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