不同声功率聚焦超声治疗不同时期胰腺癌疗效分析

Analysis of Therapeutic Effect of Different Sound Power Focused Ultrasound on Pancreatic Cancer in Different Periods

目的:对不同声功率聚焦超声治疗不同时期胰腺癌疗效进行分析。方法:以胰腺癌患者为研究对象,分为低功率组和高功率组,其中低功率组治疗功率为100249 W,高功率组治疗功率为250350 W,以疼痛缓解效果、肿瘤坏死体积和体积消融率、血管内皮生长因子(vascular endothelial growth facto,VEGF)和肝细胞生长因子(hepatocyte growth factor,HGF)水平、并发症和生存时间为指标,评价治疗效果。结果:低功率疼痛缓解总有效率为97.5%,高功率组总有效率为92.5%,两组比较无显著差异(P>0.05);所有患者的胰腺癌肿瘤均呈现不同程度的坏死,且坏死区域体积在13个月内逐渐缩小,表现为增强扫描无强化,肿瘤周围存在环形强化带;高功率组IIIIV期患者的肿瘤体积消融率显著高于低功率组(P<0.05);与治疗前相比,低功率组和高功率组IIIIV分期患者的VEGF和HGF水平均显著下降,与低功率组相比,高功率组各时期VEGF和HGF水平降低更显著(P<0.05);高功率组和低功率组并发症发生率分别为12.5%和15.0%,经比较无统计学差异(P>0.05);治疗后低功率组患者中位生存期为6.37±1.13个月,高功率组患者中位生存期为6.72±1.34个月,经比较无显著差异(P>0.05)。结论:不同声功率聚焦超声消融治疗不同时期胰腺癌均有较好疗效,减轻患者疼痛,延长中位生存期,安全性较好。

Objective:To analysis of the therapeutic effect of different sound power focused ultrasound on pancreatic cancer in different periods.Methods:The patients with pancreatic cancer were divided into low-power group and high-power group.The treatment power of low-power group is 100249 W,and the treatment power of high-power group is 250350 W.The therapeutic effect was evaluated using pain relief effect,tumor necrosis volume and volume ablation rate,VEGF and HGF levels,complications and survival time.Results:The total effective rate of low power is 97.5%,the total effective rate of high power group is 92.5%,there is no significant difference between the two groups(P>0.05).Pancreatic cancer tumors of all patients showed varying degrees of necrosis,and the volume of the necrotic area gradually reduced within 1 to 3 months,which showed that the enhancement scan had no enhancement,and there was a ring-shaped enhancement zone around the tumor;The tumor volume ablation rate in the stage III-IV patients in the high-power group was significantly higher than the low-power group(P<0.05).Compared with before treatment,the levels of VEGF and HGF in patients in low-power group and high-power group III to IV stage were significantly decreased.Compared with the low-power group,the levels of VEGF and HGF in the high-power group in each period decreased more significantly(P<0.05).The incidence of complications in the high-power group and the low-dose group were 12.5%and 15.0%,respectively,and there was no statistical difference(P>0.05)after comparison.After treatment,the median survival time of patients in the low-power group was 6.37±1.13 months,and the median survival time of patients in the high-power group was 6.72±1.34 months.There was no significant difference(P>0.05).Conclusion:Different sound power focused ultrasound ablation has better efficacy in treating pancreatic cancer in different periods,reducing patients’pain,prolonging the median survival time,and having better safety.