乳腺癌术后病人HIFU、RT去势治疗的临床研究——高聚焦超声治疗技术的新应用

The clinical studying of HIFU and RT castrating for breast cancerous patients

目的 探讨高危乳腺癌根治术后病人HIFU去势治疗的安全性、有效性。方法 52例乳腺癌术后病人被随机分为HIFU去势治疗组 (2 6例 )和RT去势治疗组 (2 6例 )。HIFU组治疗 2次 / 5天 ,焦域声强 0 9- 1 2kW/ ;RT组照射 ,DT1 4 - 1 8Gy/ 7- 9次 / 9- 1 1天。结果 治疗 1月后 ,与治疗前相比 ,HIFU组其血中E1、E2激素水平显著下降 (P <0 0 1和P <0 0 0 1 ) ;RT组E1、E2激素水平显著下降 (P <0 0 5和P <0 0 1 ) ;HIFU组E1、E2激素浓度较RT组E1、E2激素浓度降低明显 (P <0 0 5) ;HIFU组‘更年期综合征’症状分布与RT组相比显著性差异 (P <0 0 1 ) ;HIFU组CD3+ 、CD4+ 有升高的趋势 ,RT组则相反 (P >0 0 5)。两组治疗后闭经发生率均为 1 0 0 % (P >0 0 5)。结论 :HIFU去势治疗疗效肯定 ,安全 ,是取代手术、放疗去卵巢治疗的非侵入性手段 。

Objective: To evaluate the safety and effectiveness of HIFU castrating for breast cancerous patients after mastectomy if they are at a high risk of recurrence. Methods: We recruited 52 consecutive patients with primary operable breast cancer who were treated with mastectomy with excision of regional lymph nodes. Patients were divided into two groups with positive ER and PR immunohistochemical staining, un-menopause and over 40 years old by random allocation. In order to castration, 26 patients received two times HIFU treatment, and the other patients received radiotherapy with DT 14-18Gy/7-9 times/9-11days.Results: At one month of after treatment, levels of serum E1 and E2 were significantly decreased comparison to before treatment in HIFU groups (P<0 01 and P<0 001); the same changes were occurred in RT groups (P<0 05 and P<0 01); the level of serum E1 or E2 in HIFU group was higher in comparison to RT groups (P<0 05); the symptoms distribution of 'climacteric syndrome' in HIFU groups were significantly different in RT groups (P<0 01) After administration HIFU treatment, CD3+ and CD4+ subset ratios increased to different degrees; the follow-up time was 4 months The incidence of amenorrhea was 100% in all patients No serious complications were seen Conclusions: We have shown that the use of HIFU in the castrating of patients with breast cancer is feasible?safe and effective This technology may provide a rapid noninvasive alterative to conventional bilateral oophorectomy or RT castration In addition, HIFU maybe enhance cell-mediated immunity in the host