高强度聚焦超声治疗原发恶性骨肿瘤的初步临床研究

High intensity focused ultrasound in the treatment of primary malignant bone tumor

目的 探讨非侵入性治疗肢体恶性骨肿瘤的保肢新方法。方法 对 4 4例四肢原发恶性骨肿瘤采用单纯体外高强度聚焦超声 (HIFU)或HIFU结合化疗进行治疗 ,并平均随访 17.6个月。结果 4 4例的生存率为 84 .1% ,并发症发生率为 18.2 %。Ⅱb期 34例中 ,30例无瘤生存 ,2例死于肺、脑转移 ,2例局部复发 ;Ⅲb期 10例中 ,带瘤生存 5例 ,1例有局部复发 ,5例死于肺转移。Enneking综合功能评分≥ 15分者 36例。结论 HIFU结合化疗治疗四肢原发恶性骨肿瘤是有效和安全的 ,保留的肢体功能良好 ,并发症少 ,有望成为一种新的保肢治疗方法。

Objective To develop a new noninvasive limb-salvaging method in the treatment of primary malignant bone tumor in the extremities. Methods Forty-four patients with primary malignant bone tumor were treated by extracorporal high intensity focused ultrasound (HIFU) with or without chemotherapy, with a mean follow-up of 17.6 months. Results The overall survival and complication rates were 84.1% and 18.2%. In 34 patients with stage Ⅱb disease, 30 were disease-free, with 2 died of tumor metastasis to brain and lung and 3 developed local recurrence. In 10 patients with stage Ⅲb disease, 5 survived with tumor, with 1 developed local recurrence and 5 died of lung metastasis. Thirty-six of 44 patients were ≥15 points by Enneking system. Conclusion High intensity focused ultrasound combined with chemotherapy for primary malignant bone tumor in the extremity is proved to be effective and safe, preserving good function in the limbs. HIFU may possibly become a new limb-salvaging treatment for this tumor.