HIFU联合清蛋白结合型紫杉醇治疗胰腺癌的临床观察

Clinical observation of high intensity focused ultrasound combined with nab-paclitaxel in treatment of pancreatic cancer

目的探讨高强度聚焦超声(HIFU)联合含清蛋白结合型紫杉醇治疗不可切除胰腺癌的安全性及有效性。方法将48例不可切除胰腺癌患者分为观察组和对照组,每组24例。观察组接受HIFU+含清蛋白结合型紫杉醇治疗,对照组接受单纯HIFU或HIFU+其他药物治疗。观察两组患者毒副反应及疗效、生存情况等。结果两组患者间客观缓解率(ORR)及疾病控制率(DCR)比较差异均无统计学意义(P>0.05)。观察组患者中位生存期(MST)及1、3、6、12个月总生存率(OSR)分别为15个月及100%、100%、79.17%、62.50%,对照组患者分别为10个月及91.67%、79.17%、66.67%、33.33%,两组患者MST和12个月OSR比较差异有统计学意义(P=0.042、0.043)。观察组患者疼痛评分、糖类抗原19-9(CA19-9)水平明显低于对照组(P=0.025、0.036),而两组患者体力状况(ECOG)评分比较差异无统计学意义(P=0.381)。两组患者均未出现Ⅲ~Ⅳ级不良反应。结论HIFU治疗胰腺癌能明显缓解疼痛和延长生存期,联合清蛋白结合型紫杉醇获益更佳。

Objective To investigate the safety and effectiveness of high intensity focused ultrasound(HIFU)combined with conjunction type paclitaxel containing albumin in the treatment of unresectable pancreatic cancer.Methods Forty-eight patients with unresectable pancreatic cancer were divided into the observation group and control group,24 cases in each group.The observation group received HIFU plus nab-paclitaxel chemotherapy and the control group received the simple HIFU or HIFU plus other drugs.The toxic and side reactions,efficacy,survival situation,etc.were observed in the two groups.Results There were no statistically significant differences in the objective response rate(ORR)and disease control rate(DCR)between the two groups(P>0.05).The median survival time(MST)and overall survival rate(OSR)at 1,3,6,12 months in the observation group were 15 months,100%,100%,79.17%,and 62.50%,respectively,while those in the control group were 10 months,91.67%,79.17%,66.67%,and 33.33%,respectively.There were statistically significant differences in MST and 12 months OSR between the two groups(P=0.042,0.043).The pain scores and carbohydrate antigen 19-9(CA19-9)level of the observation group were significantly lower than those of the control group(P=0.025,0.036),but there was no statistically significant difference in the performance status(ECOG)score between the two groups(P=0.381).There were no adverse reactions fromⅢtoⅣin both groups.Conclusion HIFU in treating pancreatic cancer can obviously relieve pain and prolong the survival period,and its combination with nab-paclitaxel is more effective.