高强度聚焦超声治疗非手术胰腺癌近期疗效评价及生存分析  

Short-term efficacy and survival analysis in patients with inoperable pancreatic cancer treated by high intensity focused ultrasound

作　　者：余怡[1] 许青[1] 朱忠政[1] 茅伟[1] 李莉[1] 李青 YU Yi;XU Qing;ZHU Zhong-zheng;MAO Wei;LI Li;LI Qing(Dept.of Oncology,Tenth People＇s Hospital,Tongji University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院肿瘤科,上海200072

出　　处：《同济大学学报（医学版）》2018年第4期61-65,共5页Journal of Tongji University(Medical Science)

基　　金：上海市卫计委重点项目(201640020)

摘　　要：目的探讨高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗非手术胰腺癌近期疗效及生存情况。方法筛选符合入组条件的非手术胰腺癌患者30例(3例患者共接受2次HIFU治疗,共计33例次),记录患者HIFU治疗前1周和治疗后1个月肿瘤标志物CA19-9和靶病灶影像学变化,对患者进行生存随访。结果 HIFU治疗后,靶病灶最大直径为(4.8±1.54)cm,与治疗前最大直径(4.67±1.50)cm相比,差异无统计学意义(P=0.328);胰腺超声造影检查提示靶病灶区血供减少,CT增强检查示靶病灶区内密度降低,M RI增强检查示T1WI信号增加,T2WI信号降低;57.7%患者血清CA19-9降低。30例患者中位生存期10.4个月(95%CI:7.93~12.8),6、12个月生存率分别为66.7%和20%。结论 HIFU治疗能够有效抑制肿瘤生长,减轻肿瘤负荷,延长胰腺癌患者的生存期,且不良反应少,是非手术胰腺癌患者的治疗方法之一。Objective To evaluate the short.term efficacy and survival of patients with pancreaticcancer undergoing high.intensity focused ultrasound （HIFU）. Methods Thirty patients with inoperablepancreatic cancer underwent 33 treatments of HIFU. The serum level of CA19.9, imaging findings andcomplications were recorded 1 month after HIFU treatment. The median survival time （MST） wascalculated by Kaplan.Meier method. Results The maximum size of tumor was not significantly changedafter HIFU treatment [before treatment （4. 8±1. 54） cm, after treatment （4. 67±1. 50） cm, P = 0. 472].Imaging examination suggested that coagulation necrosis occurred in the target lesion and the bloodsupply was reduced or disappeared in the enhanced images; serum CA19.9 levels were decreased in57. 7% patients. The medium survival time （MST） was 10. 4 months（95%CI： 7. 93 12. 8）; 6.month and 1.year survival rates were 66. 7% and 20% respectively. Conclusion HIFU may benefit to advancedpancreatic cancer patient by stabilizing tumors, alleviating tumor burden and prolonging survival with lesscomplications, which can be chosen as a palliative treatment in patients with inoperable pancreatic cancer.

关 键 词：胰腺癌 高强度聚焦超声 生存分析 

分 类 号：R735.9[医药卫生—肿瘤]