HIFU联合化疗治疗结直肠癌肝转移患者的临床观察

Clinical observation of HIFU combined with chemotherapy in the treatment of colorectal cancer patients with liver metastasis

目的评估高强度聚焦超声(HIFU)联合化疗在治疗结直肠癌肝转移(CRLM)中的安全性及有效性,为治疗结直肠癌肝转移提供可行治疗方法。方法本研究一共回顾性研究48例患者,所有患者原发灶均已通过手术切除且经病理证实为结直肠癌,采用超声引导下的HIFU治疗,从肿瘤深部到浅层逐层重复超声,实现靶区消融。结果其中最常见的不良事件为肝酶指标升高,其次是水肿及疼痛,没有严重不良事件发生。第一次海扶治疗的客观有效率为100.0%,实际实体肿瘤平均消融率为84.1%,平均随访时间为25.5个月,所有患者中位无进展生存期(PFS)为10个月,2年总生存率为35.0%,MTS为30个月。结论本研究提示HIFU治疗是安全有效的,能获得肿瘤应答率及长期预后,对于不适合进行外科手术或其他局部治疗的患者提供新思路。

Objective To evaluate the safety and efficacy of high intensity focused ultrasound(HIFU)combined with chemotherapy in the treatment of CRLMs,and to provide a feasible treatment.Methods A total of 48 patients were retrospectively studied in this study,all of whom had undergone surgical resection of the primary lesions and were confirmed to be colorectal cancer by case.Ultrasound-guided HIFU therapy was used to achieve target ablation from deep to superficial tumor by repeated ultrasound.Results The most common adverse events were elevated AST and ALT,followed by skin edema and pain,and no serious adverse events occurred.First treatment objective effective rate was 100.0%,the actual entity tumor ablation rate is 84.1%on average.The mean follow-up time was 25.5 months.All patients with median PFS was 10 months,2 years overall survival rate was 35.0%,MTS was 30 months.Conclusion This study suggests that HIFU is safe and can achieve tumor response rate and long-term prognosis,providing a idea for patients who are not suitable for surgery or other local treatments.