Radiation therapy of liver cancer
Radiation therapy of liver cancer has become the treatment of advanced surgical indications per liver cancer as a major means. Radiotherapy is gradually improving. 1973 Collaborative Group analysis of liver cancer in Shanghai China 3245 cases of liver cancer treatments, radiotherapy group 1-year survival rate was 19.0%, if the total dose over 4000cGy, up 29.2%. Effects after surgery. Swiss high-order 1981 and other reports, mainly in the mobile bar irradiation in the treatment of advanced liver cancer, 1 year survival rate was 32.0%; later, they reported with hepatic arteriography as a radiation therapy treatment of tumor located in the section earlier in some patients, one year survival rate of 70% (21/30), 5-year survival rate was 12.5% (3 / 24). At present, the accelerator is about 90% of patients after treatment, the tumor reduced 25% or more, about half of the narrowing greater than 50%. Tumor less than 5 centimeters, 2-year survival rate after radiotherapy was 46%, while larger than 5 cm in only 17%. Generally believed that the liver tumor is not sensitive to radiation, radical dose of at least 60Gy, this dose exceeds the tolerance dose of normal liver Moreover, the majority of clinical treatment to patients they were all in patients with advanced, localized tumors are often large, and most associated with different degrees of cirrhosis of the liver, to give a large volume of high doses of radiation without producing radiation hepatitis is not possible. Therefore, only give less than the amount of normal liver tolerance dose, and thus inhibit tumor growth radiotherapy can only play the role of palliative care. However, clinical practice shows that once you have the right, radiotherapy can relieve symptoms and prolong life, without a significant increase in side effects and complications of treatment of patients, few patients get a longer lifetime.
Liver cancer radiotherapy, radiotherapy is usually limited than for large unresectable hepatocellular carcinoma, a single nodule; a small number of portal vein thrombosis is not a taboo; cirrhosis serious disease with ascites should not be yellow, but the individual is not hepatic portal pressure caused by liver cancer after radiotherapy after Yellow Fever often due to tumor shrinkage and the yellow plague subsided. The rapid development of liver inflammation, the condition dangerous, harmful element given radiotherapy benefit I am afraid, is not suitable. For a larger tumor masses, invasion and liver doors and large blood vessels, complete surgical resection element method can be planted tube surgery, brachytherapy.
As palliative treatment of liver cancer radiotherapy is the nature of radiation field, including local tumor only, without including the liver lymphatic drainage area. Of bulky liver cancer, only local radiotherapy or surgery for implantation brachytherapy. If the radiation field size> 200c when the radiation field can move the section technique. Of the liver associated with disseminated bulky, and the first for the local mass exposure, if there are local tumor response to radiotherapy, tumor regression, you can then use the whole liver irradiation. Diffuse type of lesion, the start can use the whole liver irradiation. Article irradiation technology on mobile than to use two relatively large radiation field as well. Due to compression by the tumor of hilar disease and dehydration caused by yellow, first exposure to hepatic portal area, to alleviate the symptoms. On total dose radiation to shine serious damage to liver function of patients is limited, as far as possible given the higher dose. Radiation dose rate can not be given too. Such as the use of conventional 1 day, 5 times a week exposure method, local Ono exposure (area less than 200 cm) ,150-200cGy / meeting; whole liver irradiation Ono 100-150cGy / meeting; whole liver irradiation section 150 mobile -200cGy / times. Liver such as use of local irradiation, accurate positioning is important, we must strive to make the radiation field to cover the entire tumor without slipping through the net, and using smaller doses, longer treatment, the cumulative total dose is large enough, merge traditional Chinese medicine the spleen qi, and chemotherapy applicable to alternate and concomitant immunotherapy. Close follow-up during radiotherapy patients to AFP, liver function, local tumor regression and patient in general. The biggest drawback of radiotherapy for the whole liver radiation causes liver damage eleven radiation hepatitis, and may inhibit immune function, this should be combined immunotherapy.Liver cancer radiation therapy, local radiotherapy for bone metastasis of liver cancer was palliative analgesic effect. Useful in treatment of liver cancer is currently reported photon knife, but still need to research their specific effects.