Systemic stoic to treat primary liver cancer

in the treatment of primary liver cancer, conventional radiotherapy can not improve thetumorlocal dose due to the technical conditions of exposure, and the efficacy is limitedLiver tolerance is positively correlated with the volume of unirradiated liver tissue, and reducing the volume of exposure significantly increases its tolerable doseThe whole body-to-body mouse technology focuses the energy of 30 cobalt-60 radioactive sources and 8500 Ci at one point by rotating the cone focus, forming a peak dose region around the focus, and guiding the different focus doses of different diameters through three collimators of different aperturesThetumorof 1 to 10 cm is treated by fitting a single or multiple focus dose, so that it can obtain high dose syrapy, while reducing the normal tissue dose and the volume of exposure around it, so as to effectively protect normal tissue, so as to achieve the therapeutic purpose of high efficacy and low injuryTreatmentwith position fixed bed and vacuum negative pressure bag to secure the patient's position, according to its lesions position using reclining or reclining, calm breathing state line enhanced CT scan, body surface marker repeated position point, CT image can be transmitted via the network to the planning system, sketching the generaltumortarget area (GTV), plan target area (PTV) and adjacent vital organs (such as stomach, duodenum, kidneys and spinal cord)According to the size of the tumor using single-target or multi-target treatment, with 50% dose line coverage of PTV 100%, 70% dose line coverage gTV more than 80% for the planning requirements50% dose line for the-square agentthe amount of the line, according to the size of the tumor, site and liver function and other conditions to give the target areathe 3 to 5 Gy / times, 5 times / week, 2 to 3 weeks to complete The total dose of PTV edge is 40 to 51 Gy, GTV Edge 60-70 Gy, and tumor center is 80 to 102 Gy In the treatment with liver protection and support treatment, the lesions adjacent to the gastrointestinal tract with the application of gastrointestinal mucosa protectors The efficacy evaluation method review edited ct, MRI, PET, AFP, liver function and blood routine at 1, 3, 6 and 12 months after treatment Evaluation criteria for WHO solid tumor recent efficacy evaluation standard , that is, complete remission (CR, tumor complete disappearance); partial remission (PR, tumor reduction of more than 50%), no change (NC, lump reduction is less than 50% or not more than 25%), progression (PD, one or more lesions increased by more than 25% or new lesions) Radiation damage is graded according to rTOG acute radiation injury standard Clinical results 123 cases of i - III primary liver cancer, which could not be operated upon a full-body sacher technique, had a primary and primary lesions CR rate of 25.7% and a total efficiency of 81.1% The median survival of patients in i/II was 36 months, with the total survival (OS) rates of 1, 2 and 3 years being 82.2%, 79.0% and 49.6%, respectively, while the median survival of phase III was 15 months, and the oS rates for 1, 2 and 3 years were 58.7%, 23.9% and 23.9%, respectively The difference in the 1 and 2-year survival rates of I/II and III periods was significant The survival rate of 1, 2 and 3 years of i.e.,pre-catheter hepatic artery chemotherapy embolism (TACE) was 100% The pre-treatment liver function status had a significant effect on survival rate Child-Pugh A,2 and 3-year survival rates were 90.3%, 85.6% and 58.3% respectively, while Child-Pugh B patients were 71.3%, 71.3% and 35.7%, respectively, while Child-Pugh C were 50%, 0 and 0, respectively Among them, the difference of a-level and C-level survival rate is significant During treatment, the incidence of acute gastrointestinal reaction in I-II was 33.8%, Grade III was 0.7%, grade I blood image decline was 21.6%, Grade II was 8.7%, grade III was 0.7%, and treatment of the disease was completed as planned During treatment with liver protection treatment, there was no liver function damage China's original, full-body knife technology with full independent intellectual property rights has a large dose focus ingenuity advantage, can extend the survival of non-surgical I/II and III stage liver cancer, worthy of further in-depth study and application (Li Ping Xia Tingyi)