高能聚焦超声热疗对晚期胰腺癌的疗效观察  

Therapeutic effect of high intensity focused ultrasound on advanced pancreatic cancer

作　　者：虞阳[1] 张宇 赵洪 于晓峰[1] 

机构地区：[1]华东医院消化内科,上海200040 [2]华东医院聚焦超声刀中心,上海200040

出　　处：《中华胰腺病杂志》2009年第3期153-155,共3页Chinese Journal of Pancreatology

摘　　要：目的观察应用高能聚焦超声热疗（high intensity focused ultrasound，HIFU）对晚期胰腺癌的治疗作用。方法39例晚期胰腺癌患者按随机表法分为单纯化疗组和HIFU＋化疗组。单纯化疗组给予吉西他滨静脉滴注；HIFU＋化疗组应用HIFU及吉西他滨静脉滴注。观察治疗后2个月肿瘤体积变化、患者疼痛缓解程度和不良反应发生率，记录治疗后3个月和6个月的生存率。结果HIFU＋化疗组肿瘤体积缩小的总有效率为80．8％，显著高于单纯化疗组的46．2％（Х^2=4．75，P=0．029）；HIFU＋化疗组疼痛缓解阳性改善率为61．5％，显著高于单纯化疗组的15．4％（Х^2=7．24，P=0．007）；两组的白细胞下降、肝。肾功能损伤和胃肠道反应的发生率无显著差异；HIFU＋化疗组患者的3个月生存率为100％（26／26），单纯化疗组为84．6％（11／13），两组无统计学差异；HIFU＋化疗组6个月生存率为76．9％（20／26），较单纯化疗组的38．5％（5／13）显著增加（Х^2=5．42，P=0．02）。结论HIFU联合吉西他滨化疗可以更有效地控制晚期胰腺癌的肿瘤生长，缓解患者疼痛，且不增加化疗的不良反应，是一种有效、安全的治疗方法。Objective To investigate the therapeutic effects of high intensity focused ultrasound （HIFU） on advanced pancreatic cancer. Methods A total of 39 advanced pancreatic cancer patients were randomly divided into treatment group and control group. Patients in treatment group were given HIFU and intravenous gemcitabine chemotherapy, while patients in control group were given intravenous gemcitabine chemotherapy only. Two months later, the changes in tumor volume, the degree of pain relief and the incidence of adverse events were measured. The 3 months and 6 months survival were recorded. Results The total effective rate of tumor volume shrinkage in treatment group was 80.8% , which was significantly higher than 46.2% in control group （Х^2= 4.75, P = 0. 029）. The degree of pain relief in treatment group was 61.5% , which was significantly higher than 15.4% in control group （ Х^2 = 7.24, P = 0. 007）. The incidences of leucopenia, liver and renal function impairment and gastrointestinal adverse events in treatment group were similar to those in control group. The 3 month survival in treatment group was 100% （26/26） , which was not significantly higher than 84.6% （11/13）in control group; while the 6 month survival in treatment group was 76.9% （20/26）, which was significantly higher than 38.5% （5/13） in control group （Х^2 = 5.42 ,P = 0.02）. Conclusions Gemcitabine chemotherapy combined with HIFU treatment was more effective for pancreatic tumor growth control and pain relief without more adverse events, which was effective and safe.

关 键 词：胰腺肿瘤 超声 高强聚焦 吉西他滨 

分 类 号：R735.9[医药卫生—肿瘤] R725.631[医药卫生—临床医学]