三维适形放疗联合高强度聚焦超声治疗中晚期胰腺癌临床疗效

Clinical effect of combination of 3DCRT and HIFU in the treatment of patients with moderate or advanced pancrease cancer

目的观察三维适形放疗(3DCRT)联合高强度聚焦超声(HIFU)治疗中晚期胰腺癌的临床疗效。方法对住院的73例胰腺癌连续病例,随意分为3DCRT+HIFU治疗组(联合治疗组)、3DCRT治疗组(放疗组)和HIFU治疗组3组。联合治疗组先行放疗,30min内接受HIFU治疗。放疗单次剂量为180～200cGy,1次/d,5次/周,总剂量5000～7000cGy;HIFU治疗每次1h,隔天一次,3次/周。结果联合治疗组、放疗组、HIFU治疗组的总有效率分别为63.64%(14/22)、44.83%(13/29)、40.91%(9/22),临床受益率(CBR)分别为95.45%(21/22)、86.21%(25/29)、86.36%(19/22);一、二年生存率分别为59.09%(13/22)、50.00%(11/22),41.38%(12/29)、24.14%(7/29),40、91%(9/22)、22.73%(5/22);中位生存期分别为17.64个月、12.43个月和12.35个月。结论 3DCRT+HIFU治疗胰腺癌具有协同增效作用,能有效的提高中晚期胰腺癌的临床疗效。

Objective To study the clinical effect of combination of three-dimensional conformal radio- therapy （3DCRT） and High intensity focused ultrasound （HIFU） in the treatment of patients with moderate or advanced pancrease cancer. Methods Seventy-three patients with pancrease cancer were randomly divided in- to 3 treatment groups： 3DCRT with HIFU （Combined therapy）, 3DCRT （radioterapy）, and HIFU. For the combined terapy group, 3DCRT was received first, followed by HIFU treatment within 30 rains. The single close of the 3DCRT was 180 ~200 cGy, once a day for 5 times a week. The total dose for patients was 5000 ~7000 cGy. I-IIFU was performed one hr a time for every other day, or 3 times a week. Results The total effective rate （ CR ＋ PR） was 63.64% （14/22） for the combined group, and 44. 83% （13/29） for the 3DCRF group, and 40. 91% （9/22） for the HIFU. The CBR （ clinical benefit response ） was 95.45% （ 21/22 ）, 86. 21% （25/29）, and 86. 36% （ 19/22）, respectively. The 1-year / 2-year survival rates of the combined group was 59.09% （13/22） 50.00% （11/22）, 3DCRT, 41.38% （12/29） 24. 14% （7/29）, and HIFU, 40.91% （9/12） 22. 73% （5/22）, respectively. The median survival periods were 17. 64 mos, 12. 43 mos, and 12. 35 mos. Conclusion The combination of 3DCRF with HIFU have the synergy effects, and hence could improve the clinical effectiveness for moderate and advanced pancrease cancer.