聚焦超声消融治疗外周型原始神经外胚层肿瘤病例分析

High-intensity focused ultrasound ablation for peripheral primitive neuroectodermal tumor clinical analysis cases

目的:初步了解聚焦超声(HIFU)消融治疗外周型原始神经外胚层肿瘤(pPNET)的临床疗效。方法:应用JC型HIFU系统,消融性治疗pPNET患者5例,其中4例既往治疗失败,出现转移或局部复发,1例为初治患者。均采用围绕HIFU消融治疗的综合治疗方法,应用MRI或CT平扫+增强,评价肿瘤局部消融疗效,通过随访进行生存评估。结果:局部消融效果评价显示:完全消融4例,部分消融1例。对5例患者随访3年,其中4例死亡,1例无瘤生存。4例出现肿瘤局部复发的时间为2～10个月。4例死亡患者生存时间为13～60个月,1例患者无瘤生存时间已超过36个月。结论:HIFU治疗pPNET的消融效果确切,联合HIFU消融的综合方法作为pPNET治疗的研究新策略,值得深入探讨。

Objective： To study on the clinical efficacy of high-intensity focused ultrasound ablation for pPNET. Methods： The Model-JC HIFU System （Chongqing HAIFU , Company） was used in five cases of pPNET, among which four cases of verified treatment failure with remote metastasis or local recurrence, one previously untreated case. All the patients are male with age ranging from 10 to 28（median age of 20） and tumor size ranged from 6 to 25 cm in diameter, with a mean diameter of 11 cm. All adopt the comprehensive treatment involving the HIFU ablation, Applying MRI or CT to evaluate the effectiveness oi local tumor ablation, and assessing overall survival time through follow-up review. Results： After treatment, tumors in four patients were completely ablated, while tumors in the rest one patient partially ablated. During the 3 years of foUow-up, four patients are dead （overall survival time is 13-60 month with a median of 20.5 months） and one patient is still tumor free after 36-months follow-up. The median time to relapse is 6.5 months in four cases of local recurrence （range 2-10 months）. Conclusion： HIFU can be used to efficiently treat the patients with pPNET. HIFU ablation combined with the other methods for pPNET is a new strategy and worthy of further exploration.