高强度聚焦超声联合立体定向放疗治疗晚期结肠癌肝转移的疗效观察

目的:对比观察高强度聚焦超声与立体定向放疗治疗晚期结肠癌肝转移的临床效果.方法:2013年2月到2015年8月选择在我院诊治的晚期结肠癌肝转移患者78例,根据平行分组的原则分为观察组与对照组各39例,对照组给予立体定向放射治疗,观察组给予高强度聚焦超声与立体定向放射治疗,都治疗观察4周,记录与随访预后情况.结果:观察组与对照组的治疗有效率分别为69.2%和38.5%,观察组的治疗有效率明显高于对照组(P<0.05).治疗期间两组的粒细胞减少、贫血、胃肠道反应、手足综合征等毒副反应发生情况对比无明显差异(P>0.05).观察组与对照组治疗后的NK细胞含量分别为(25.10±3.49)%和(20.14±4.67)%,都明显高于治疗前的(12.45±2.01)%和(12.24±2.20)%(P<0.05),治疗后观察组的NK细胞含量明显多于对照组(P<0.05).随访至今,观察组与对照组的无进展生存时间为(18.23±4.19)个月和(14.89±3.82)个月,观察组明显长于对照组(t=3.491,P<0.05).结论:高强度聚焦超声与立体定向放疗治疗晚期结肠癌肝转移的合用能提高近期疗效,不会增加毒副反应的发生,延长患者的生存时间,且作用机制可能与有效改善外周血免疫功能有关.

Efficacy of high intensity focused ultrasound and stereotactic radiotherapy for the treatment of liver metastasis in patients with advanced colon cancer

Objective:To observe the clinical effects of high intensity focused ultrasound and stereotactic radiotherapy for the treatment of liver metastasis in patients with advanced colon cancer.Methods:From February 2013 to August 2015,78 liver metastasis in patients with advanced colon cancer for treatment were selected and were divided into observation group and control group with 39 patients in each group according to the principle of parallel.The control group was received stereotactic radiotherapy,and the observation group was treated with high intensity focused ultrasound and stereotactic radiotherapy for the treatment.All patients were observed for 4 weeks,and prognosis was recorded.Results:The effective rates of the observation group and the control group were 69.2% and 38.5% respectively,and the effective rate of the observation group was significantly higher than that of the control group (P<0.05).There were no significant differences in the incidence of adverse reactions of granulocyte reduction,anemia,gastrointestinal reactions,and hand foot syndrome between the two groups (P>0.05).The content of NK cells in the observation group and the control group after treatment were (25.10±3.49)% and (20.14 ±4.67)%,which were significantly higher than that before treatment [(12.45±2.01)% and (12.24±2.20)%](P<0.05),and after treatment the observation group was higher than that of control group (P<0.05).Up to now,the progression free survival time of the observation group and the control group were (18.23±4.19) months and (14.89±3.82) months,and the observation group was significantly longer than that of the control group (t=3.491,P<0.05).Conclusion:The high intensity focused ultrasound and stereotactic radiotherapy for the treatment of liver metastasis in patients with advanced colon cancer can improve the curative effect and does not increase the toxicities,can prolong the survival time of patients,and its possible mechanism may be related to the improvement of the immune function of peripheral blood.