高强度体外聚焦超声用于难治性盆腔内复发/转移癌的临床初探

Study on advanced pelvic recurrent/metastatic cancer treated with HIFU

目的探讨高强度体外聚焦超声(HIFU)治疗对经综合治疗后在盆腔内不能手术的难治性复发/转移癌的治疗价值。方法对同期经手术、放疗/化疗等多种综合治疗后在盆腔内难治性复发/转移癌晚期患者,分别采用HIFU+放/化疗(21例)和放/化疗(26例)治疗,将两组的疗效(患者的客观指标、主观症状改善程度)及毒副反应进行比较。结果HIFU组近期总有效率85.7%,对照组26.9%,两组比较P值=0.002。两组间生存期无显著差异,中位生存期分别为7个月和5个月;肿瘤平均消退值P<0.01。HIFU组主观症状改善程度优于对照组,两组间疗后Karnofsky评分P值=0.001。HIFU组毒副反应较对照组明显轻而低,主要为可耐受的骨痛或坐骨/闭孔神经痛、轻度皮肤灼伤及轻度消化道反应。两组严重并发症发生率分别为9.4%和50.0%,P值=0.001;消化道反应发生率分别为28.8%(6/21)和73.1%(19/26),P值=0.006。结论HIFU用于经综合治疗后不能手术的难治性盆腔内复发/转移癌,对局部病灶的控制有较好的近期疗效,作为一种姑息性治疗,其具有较高安全性,可提高患者的生活质量。

Abstract： [Objective] To evaluate the effect of High Intensity Focused Ultrasound（HIFU）technology for treating Patients with Advanced recurrent/metastatic cancer in pelvis. [Methods] In the same period, the patients with ad- vanced recurrent/metastatic tumor were assigned to HIFU treatment group or control group, who had been given op- eration, or radiotherapy or chemotherapy before this treatment. They were given HlFU-therapy and/or radiotherapy and/or chemotherapy concomitantly. Tumor size ,subjective symptoms ,side-effect and survival time and ratio were compared between two groups. [Results] After treatment short term overall effective rate of HIFU group was 85.7% and control group 26.9%, respectively （P =0.002）. Overall survival status calculated using Kaplan-Meier analysis, two groups~ median survival times were 7M and 5M, respectively. Tumor size becoming smaller after treatment in HIFU group were （23.1＋16.5） mm and that in control （2.3＋13.2） ram, respectively （P =0.002）. Results compared with Karnofsky grade showed obviously significance between groups after therapy（P =0.001）. In HIFU group, side-effect was Slighter than that in control group and the serious complications occurred were lower, too （P =0.00l）. [Conclu- sion] The results show that HIFU therapy has better short term results for advanced recurrent/metastatic cancer in pelvis.As a palliative treatment, it is safe and effective.