高强度聚焦超声联合健择治疗晚期胰腺癌的临床研究

目的探讨高强度聚焦超声（HIFU）联合健择治疗晚期胰腺癌的有效性。方法将46例不能切除的晚期胰腺癌无黄疸病人随机分为：HIFU联合健择组24例，单用健择组22例。全部病例随访2～18个月。Kaplan-Meier法进行生存分析，计算6个月、12个月生存率和中位生存期；采用LogRank法进行组间比较。两组治疗后的疼痛缓解率采用X^2检验。结果HIFU联合健择组的24例病人中位生存时间为10．56个月，6个月和12个月的生存率分别是75．0％和30．9％；而单用健择组的22例病人中位生存时间为6．71个月，6个月和12个月的生存率分别是36．4％和13．0％。两组比较，HIFU联合健择组优于单用健择组，差异有显著性（P〈O．01）。HIFU联合健择组24例病人的疼痛缓解率（疼痛强度降低或消失，止痛剂减少或停止应用）87．5％；而单用健择组22例病人的缓解率为36．4％。两组比较，HIFU联合健择组明显优于单用健择组（P〈O．01）。结论HIFU联合健择组治疗晚期胰腺癌的疗效明显优于单用健择组，因此本方法有望成为治疗晚期胰腺癌的一种有效手段。

High intensity focused ultrasound therapy in combination with gemcitabine for advanced pancreatic carcinoma

Objective To study high intensity focused ultrasound therapy (HIFUT) in combination with gemcitabine for treatment of advanced pancreatic carcinoma (APC). Methods A total of 46 patients were randomized into 2 groups. The patients in group A (n=24) received HIFUT in combination with gemcitabine and those in group B (n=22) were given gemcitabine alone. The follow-up time was 2-18 months in both groups. The median survival time, 6-month and 12-month survival rates were calculated by Kaplan-Meier method and LogRank test. The pain remission rate of the 2 groups was compared by x2 test. Results The median survival time, 6-month and 12-month survival rates were significantly higher in group A than in group B (10. 56 months vs. 6. 71 months, 75. 0% vs. 36. 4%, 30. 9% vs. 13. 0%, P<0. 01). Meanwhile, the pain remission rate was markedly higher in group A than in group B (87. 5% vs. 36. 4%, P<0. 01). Conclusions HIFUT in combination with gemcitabine is better than gemcitabine alone. The former may become of the most effective treatments for APC.