高强度聚焦超声治疗晚期胰腺癌128例分析

Analysis on 128 cases of advanced pancreatic cancer treated by high intensity focused ultrasound

目的评价高强度聚焦超声（HIFU）治疗晚期胰腺癌的作用、安全性和有效性。方法分析了128例晚期胰腺癌患者（Ⅲ期41例，Ⅳ期87例）接受HIFU治疗，通过临床症状、实验室检查、影像学变化和生存期等观察疗效。结果全组病例未发生严重不良反应，22．9％患者癌抗原19—9下降，疼痛缓解，有效率为72．5％。局灶近期疗效为部分缓解11．7％，稳定70．3％，进展18．0％。1年生存率为16．7％，中位生存期为7．0个月。其中Ⅲ期患者1年生存率为28．5％，中位生存期为9．0个月；Ⅳ期患者1年生存率为10．8％，中位生存期为6．0个月。结论HIFU治疗能够有效稳定瘤灶、缓解疼痛、延长患者生存期且不良反应少，显示了良好的临床价值。

Objective To evaluate the analgesic efficacy and effect of high intensity focused ultrasound （HIFU） in the treatment of advanced pancreatic cancer. Methods 128 patients with pancreatic cancer （ Ⅲ stage 41 case, Ⅳ stage 87 case） were treated by HIFU. According to some parameters, such as the clinical symptoms, imaging examinations and survival analysis to assess the efficacy of HIFU treatment. Results 22.9%0 patients＇ serum Ca19-9 decreased. The cancer pain was relieved in 72.5% patients. Coagulated-necrosis by CT/MRI examination was observed. PR, SD and PD of all were 11.7%, 70.3% and 18.0% respectively. 1-year survival rate was 16.7% for all patients, and median survival time was 7.0 months. 1-year survival rate and median survival time for Ⅲ stage group were 28.5% and 9.0 months, that of 10.8% and 6.0 months for IV stage group respectively. Conclusion HIFU may benefit to advanced pancreatic cancer patient by stabilizing tumors, relieving pain and prolonging life expectancy with less side effects.