高强度聚焦超声联合吉西他滨治疗不可切除胰腺癌的临床疗效

Clinical study of high-intensity focused ultrasound therapy in combination with gemcitabine for unresectable pancreatic carcinoma

目的探讨高强度聚焦超声(HIFU)联合吉西他滨治疗不可切除胰腺癌的疗效和安全性。方法将48例在我院确诊为不可切除胰腺癌患者随机分为HIFU联合吉西他滨组和单纯吉西他滨化疗组。观察治疗后临床受益率、近期有效率、生存率和不良反应。结果联合治疗组和单纯吉西他滨治疗组相比临床受益率(CBR)(83.3%vs 30.0%,P<0.05)、中位生存期(MST)(10.4个月vs 6.4个月,P<0.05)、6和12个月生存率(73.8%,35.2%vs 52.3%,17.3%,P<0.05)差异均具有统计学意义。而疾病控制率(DCR)(82.1%vs 60.0%,P>0.05)和不良反应率两组差异无统计学意义。结论 HIFU是一种安全,无创,疗效确切地治疗胰腺癌的方法。HIFU联合吉西他滨化疗治疗不可切除胰腺癌不良反应无明显增加,且能有效地提高CBR和DCR,延长生存期。

Objective To study the effect and security of the combination therapy of high - intensity focused ultrasound （ HIFU ） with gem- citabine for unresectable pancreatic carcinoma. Methods 48 patients with correct diagnosis of advanced unresectable pancreatic carcinoma were divided into two groups , as the HIFU and gemcitabine combination therapy group and the gemcitabine chemotherapy group. The aver- age survival time, 6 -month and 12 -month survival rates, clinical benefit rates, disease control rates and side effects were evaluated after treatment. Results Compared with the chemotherapy group, the combination therapy group presented higher CBR（83.3% vs 30.0%, P 〈 O. 05） as well as better 6 and 12 month survival （73.8% vs 52.3%, P 〈 0.05 ; 35.2% vs 17.3%, P 〈 0.05 ） and longer MST（ 10.04 ms vs 6.4ms）. And there were no differences between the two groups in DCR （ 82.1% vs 60.0% , P 〉 0.05 ） and adverse effect. Conclusion HIFU is supposed to be an effective and safe therapy for unresectable pancreatic carcinoma. The combination therapy of HIFU and GEM can increase the CBR and DCR, and prolong the survival time without increasing side effects.