高强度聚焦超声治疗胰腺癌疼痛的荟萃分析

A meta-anaiysis of high intensity focused ultrasound （HIFU） therapy on pain relief in pancreatic cancer

目的探讨高强度聚焦超声（HIFU）对胰腺癌疼痛的疗效及其安全性。方法收集2001年至2007年2月期间国内应用HIFU治疗胰腺癌疼痛的资料较为齐全的文献进行荟萃分析。对所选文献的HIFU机器型号、治疗剂量、胰腺癌缓解率、疼痛总缓解率、疼痛消失率以及并发症等方面进行详细记录，着重分析治疗后胰腺癌癌痛缓解率和消失率以及不良反应发生率等指标。结果共有16篇413例患者纳入分析，胰腺癌疼痛总缓解率为31．3％～100％（中位缓解率为80．0％），疼痛消失率为10．8％～88．9％（中位消失率为28.0％）；联合化疗药物可显著增强其镇痛作用；不良反应少，少数可出现淀粉酶升高、AP、局部腹膜炎等并发症。结论HIFU为缓解胰腺癌疼痛的安全有效措施。

Objective To investigate the efficacy and safety of HIFU therapy on pain relief in pancreatic cancer. Methods The literatures about HIFU therapy on pain relief in pancreatic cancer published from 2001 to Feb 2007 were collected and meta-analysis was performed. The type of HIFU used, therapeutic dosage, pain remission rate, pain-free rate and complication rate were recorded. Results Totally 413 cases in 16 reports were analyzed. The total pain remission rate was 31.3% - 100% （median pain remission rate was 80.0% ） , Total pain-free rate was 10.8% - 88.9% （median pain free rate was 28.0% ）. Chemotherapy combined with HIFU could significantly increase the effect of HIFU therapy. There was few complications were observed, including hyperamylasemia, acute pancreatitis, local peritonitis. Conclusions HIFU was an effective and safe therapy for the pain relief in pancreatic cancer.