高强度聚焦超声治疗消化道肿瘤腹膜后淋巴结转移癌67例疗效观察

目的探讨高能聚焦超声（HIFU）治疗胃肠道肿瘤腹膜后淋巴结转移癌的疗效及安全性。方法应用HIFUNIT9000型肿瘤超声治疗机,对67例胃肠道肿瘤腹膜后淋巴结转移癌患者进行治疗。结果完全缓解率为8．95％（6／67）,部分缓解率为28．35％（19／67）,有效率为37．31％.所有病例均未出现胰液外漏、腹腔内出血、皮肤烧伤等并发症,结论HIFU是治疗腹膜后淋巴结转移癌的1种安全有效的局部治疗方法。     

子宫转移癌高强度超声聚焦治疗后并发肠瘘1例报告

1　病例介绍患者女性 ,70岁。于 1985年 5月 2 1日经腹会阴做直肠癌切除及腹壁人工造口术 ,术后化疗 6个疗程。病理诊断为印戒细胞癌 ,肿瘤直径为 2ｃｍ ,肠周淋巴结转移 (5 /5 )。 1999年 2月会阴区和下肢又出现疼痛、尿频、阴道有异常分泌物 ,病理细胞学检查找到癌细胞。采用放疗 (5 0Ｇｙ)后 ,症状缓解。 2 0 0 1年 1月肿瘤再次复发 ,且症状逐渐加重 ,盆腔、子宫、右侧肾上腺均出现大小不等的肿瘤病灶 ,骨扫描证实骨盆局部有转移。给予化疗无效 ,出现骨髓抑制。曾出现不完全性肠梗阻 ,经保守治疗后症状缓解。 4个月后夜尿次数增多 ,4～ 6…     

HIFU联合放疗同步治疗腹膜后淋巴结转移癌26例疗效观察

腹膜后淋巴结转移癌在临床上颇为常见，多由消化系统恶性肿瘤转移而来，病期较晚，且易导致患者腹痛等不适，使患者生活质量下降。由于受胃肠及脊髓的限制，单一放疗只能用姑息剂量，缓解期短。笔者从2006年10月～2007年10月采用高能聚焦超声热疗（HIFU）同时联合普通放疗治疗各类腹腔转移癌26例，取得了满意的疗效，现报告如下。     

高强度聚焦超声治疗子宫肌瘤30例疗效观察

子宫肌瘤是女性（30～50岁）生殖器中最常见的1种良性肿瘤,对瘤体直径在2～5 cm之间,且患者拒绝手术,采用高强度聚焦超声（high intensitg focused uocused,HIFU）治疗系统,是较好的物理治疗肿瘤的选择方法。我们采用HIFU治疗30例子宫肌瘤患者,取得了较理想的疗效,现报告如下。     

高强度超声聚焦热疗序贯FOLFOX-4方案治疗胃癌腹膜后淋巴结转移

[目的]观察高强度超声聚焦热疗序贯FOLFOX-4方案治疗胃癌腹膜后淋巴结转移与单纯FOLFOX-4方案治疗的疗效及安全性。[方法]85例胃癌腹膜后淋巴结转移患者随机分成两组,即高强度超声聚焦热疗序贯FOLFOX-4方案组（试验组,n=44）和单纯FOLFOX-4方案组（对照组,n=41）,观察两组的治疗疗效和不良反应。[结果]最终两组的病例为44例和40例（对照组有1例患者死亡）。试验组的治疗有效率为68.2%,对照组为45.0%,两组差异具有统计学意义（P〈0.05）。两组患者治疗后的疼痛和生活质量得到不同程度的改善,且试验组的改善程度均高于对照组（P〈0.05）。试验组和对照组的不良反应发生率没有明显差异（P〉0.05）。两组1年生存率没有明显差异（P〉0.05）。[结论]高强度超声聚焦热疗序贯FOLFOX-4方案化疗治疗胃癌腹膜后淋巴结转移较单纯FOLFOX-4方案更加有效。     

高能超声体外聚焦治疗腹膜后转移淋巴结的临床观察

目的了解FEP-BY01型高能超声体外聚焦肿瘤热疗机、用于治疗腹膜后转移淋巴结的有效性和临床可行性.方法应用FEP-BY01型高能超声体外聚焦肿瘤热疗机治疗腹膜后转移淋巴结45例、其中辅助放疗28例.结果治疗结束后一个月、复查彩超和CT提示CR 37.78%(17/45),PR 40%(18/45)PC22.22%(10/45).全组病例治疗中无损伤、无痛苦、无副作用.结论高能超声体外聚焦(FEP)技术,用于治疗腹膜后转移淋巴结是有效的、临床可行的.     

三维适形放疗联合高强度聚焦超声治疗腹膜后转移癌的疗效观察

腹膜后淋巴结转移癌在临床上颇为常见,多南消化系统恶性肿瘤转移而来,病期较晚。由于受胃肠及脊髓的限制,单一放疗只能用姑息剂量,缓解期短。我们从2006年1月～2008年6月采用三维适形放疗联合高强度聚焦超声治疗各类腹腔转移癌22例,取得了满意的疗效,现报告如下。     

超声造影评价高强度聚焦超声治疗肝转移癌疗效1例

1 病倒报告 患者女，71岁。因右侧硬腭肿瘤放疗后1年，发现肝转移半年，于2007年8月14日入院。患者于2006年1月发现右侧上颈部多个肿大淋巴结，在外院检查发现硬腭肿物，经活检病理诊断为右侧硬腭低分化鳞癌。化疗2周期后行根治性放疗。2007年2月肝脏B超检查发现肝内多发转移，接受1周期化疗后自行终止治疗。     

高强度聚焦超声治疗21例结直肠癌肝转移

[目的]探讨高强度聚焦超声（HIFU）治疗结直肠癌肝转移患者的有效性及安全性。[方法]21例结直肠癌肝转移患者37个病灶行HIFU治疗,观察患者的生命体征、肿瘤转归和毒副反应情况。[结果]随访观察37个肿瘤病灶中,22个病灶体积缩小50%,11个病灶体积保持稳定,1例4个病灶出现新转移灶而放弃治疗。平均随访17个月（5～36个月）,存活12例,中位生存时间为17个月,6、12、24、36个月生存率分别为94.74%、87.45%、61.84%和32.98%。8例患者皮肤出现条索状灼痕。[结论]HIFU是一种安全、有效的治疗结直肠癌肝转移的方法。     

高强度聚焦超声治疗肿瘤

近几年国内外开展了高强度聚焦超声(HIFU)治疗肿瘤新技术,现对其作用机制、适应证、疗效判断和影像学监测的评价、局限性等问题进行简要综述.     

高强度聚焦超声治疗乳腺癌骨转移的疗效

目的:研究高强度聚焦超声（high intensity focused ultrasound,HIFU）治疗乳腺癌骨转移的疗效。方法:选取乳腺癌骨转移患者50例,随机将患者分为观察组与对照组,每组各25名。观察组采用HIFU治疗,对照组采用放疗。观察2组患者治疗前后的疼痛缓解率及骨显像浓集影区别。结果:观察组与对照组疼痛缓解显效分别为15例（60%）、5例（20%）（P＜0.01）,观察组与对照组治疗前后骨显像CR分别为19例（76%）、1例（4%）（P＜0.01）。结论:HIFU是一种从体外无创治疗骨转移瘤的有效手段。与传统治疗方法相比,治疗时间短,一般需2~3小时,治疗即可完成。局部复发后可再次应用HIFU治疗。HIFU治疗将成为骨转移的又一有效治疗手段。     

Extracorporeal high intensity focused ultrasound treatment for patients with breast cancer

Purpose. To investigate the safety, efficacy and feasibility of using high-intensity focused ultrasound (HIFU) as a non-invasive treatment for patients with breast cancer.Patients and Methods. Twenty-two patients with breast cancer were enrolled into this non-randomized prospective trial. Disease TNM stage was classified as stage I in 4 patients, stage II_A in 9 patients, stage II_B in 8 patients, and stage IV in 1 patient. Tumor size ranged from 2 to 4.8 cm in diameter (mean 3.4 cm). All patients received chemotherapy, radiation and tamoxifen, following HIFU for the primary lesions. Outcome measures included radiological and pathologic assessment of the treated tumor, cosmesis, and local recurrence. A cumulative survival rate is calculated by using the Kaplan–Meier method.Results. No severe complications were encountered after HIFU. Post-operative imaging demonstrated positive response and regression of all treated lesions. Follow-up biopsy revealed coagulation necrosis of target tumor and subsequent replacement by fibroblastic tissue. After a median follow-up of 54.8 months, 1 patient died, 1 was lost to follow-up, and 20 were still alive. Two of 22 patients developed local recurrence. Five-year disease-free survival and recurrence-free survival were 95% and 89%, respectively. Cosmetic result was judged as good to excellent in 94% of patients.Conclusions. HIFU treatment is safe, effective, and feasible for patients with breast cancer. But, large-scale, multiple-center clinical trials will be needed to determine the future role of this novel modality.     

高强度聚焦超声治疗肝癌的近期疗效分析

目的探讨高强度聚焦超声(HIFU)治疗肝癌的近期疗效。方法44例肝癌患者通过全身麻醉、超声肿瘤定位进行HIFU治疗,观察HIFU治疗前后临床症状以及肝功能、AFP、MRI的变化。结果HIFU治疗后患者的临床症状缓解率为87.5％(28/32),其中3例患者少量腹水自行消失。治疗前患者的ALT为(79.73±12.31)U/L,AST为(103.47±24.55)U/L;治疗后ALT、AST降至正常水平者分别占84.6％(22/26)和73.5％(25/34),AFP降低超过原数值50％者占64.3％(18/28),MRI显示肿瘤治疗区已凝固性坏死,肿瘤血供减少或消失。结论HIFU对肝癌患者的治疗是确切有效的,可成为肝癌无创局部治疗的新方法。     

高强度聚焦超声治疗肿瘤

主要介绍高强度聚焦超声(HIFU)的作用机制、治疗适应证、疗效判断、局限性和未来发展等问题.虽然HIFU治疗肿瘤这项新技术近几年有了较大的发展,但是HIFU的临床应用仍然受到一定的限制,需要进行多中心研究以明确HIFU的临床疗效.     

Advances of high intensity focused ultrasound (HIFU) for pancreatic cancer

Abstract

High intensity focused ultrasound (HIFU) is a novel therapeutic modality. Several preclinical and clinical studies have investigated the safety and efficacy of HIFU for treating solid tumours, including pancreatic cancer. Preliminary studies suggest that HIFU may be useful for the palliative therapy of cancer-related pain in patients with unresectable pancreatic cancer. This review provides a brief overview of HIFU, describes current clinical applications of HIFU for pancreatic cancer, and discusses future applications and challenges.     

Clinical and future applications of high intensity focused ultrasound in cancer

High intensity focused ultrasound (HIFU) or focused ultrasound (FUS) is a promising modality to treat tumors in a complete, non invasive fashion where online image guidance and therapy control can be achieved by magnetic resonance imaging (MRI) or diagnostic ultrasound (US). In the last 10 years, the feasibility and the safety of HIFU have been tested in a growing number of clinical studies on several benign and malignant tumors of the prostate, breast, uterine, liver, kidney, pancreas, bone, and brain. For certain indications this new treatment principle is on its verge to become a serious alternative or adjunct to the standard treatment options of surgery, radiotherapy, gene therapy and chemotherapy in oncology. In addition to the now clinically available thermal ablation, in the future, focused ultrasound at much lower intensities may have the potential to become a major instrument to mediate drug and gene delivery for localized cancer treatment. We introduce the technology of MRI guided and ultrasound guided HIFU and present a critical overview of the clinical applications and results along with a discussion of future HIFU developments.     

高强度聚焦超声治疗前列腺癌的研究现状

 作为常见肿瘤的前列腺癌，其发病率逐年上升。手术是局限性病变的主要治疗手段，但仍然有一定的并发症和死亡率。放化疗等传统治疗手段也有其适应证和疗效的局限性，迫切需要有效的微创治疗方法。近年发展起来的高强度聚焦超声（HIFU）正日益受到人们的关注，对其作用机制、设备原理、适应证、治疗效果和局限性等问题作综述。     

高强度聚焦超声治疗肿瘤的临床疗效评价

高强度聚集超声(HIFU)通过破坏肿瘤的血管或直接杀死肿瘤细胞,达到杀死、减小肿瘤,减少肿瘤转移,并且对晚期肿瘤具有止痛作用,提高患者生活质量.HIFU联合其他疗法对肿瘤细胞的杀死起进一步的协同作用,更好地杀死肿瘤细胞,降低远期复发率.在实体性肿瘤的治疗中,HIFU治疗具有许多优点,创伤小、不良反应小、可重复治疗等.     

Use of High Intensity Focused Ultrasound for Treating Malignant Tumors

OBJECTIVE To investigate the efficacy and side effects of high intensity focused ultrasound(HIFU) in the treatment of malignant solid tumors. METHODS Thirty patients who refused surgery and/or were refractory to chemotherapy were treated by HIFU alone, with the efficacy and side effects monitored as follows: observation of vital organ signs; functional assay of important organs; imaging examinations including: digital subtraction angiography (DSA), CT, MRI, single photon emission computed tomography (SPECT), large core needle biopsy, complications and metastasis. RESULTS After HIFU therapy, the vital signs remained stable and the functions of the heart, lung, kidney and liver were also normal. DSA images showed that small or larger arteries were not damaged. After a follow-up of 10-38 months(mean 23.1 months), 26 patients(87%) were alive. The volume of the tumor underwent complete regression in 10 patients. Shrinkage of the tumor volume ≥50% was observed in 13 patients. Eight of 13 patients were examined by large core needle biopsy, all showing necrosis and/or fibrosis though 3 patients(10%) had local recurrence. Two of these were retreated again by HIFU and the locally recurrent tumors were controlled. New metastases developed in 5 patients after H IFU. Two patients suffered from peripheral nerve injuriy and they have recovered during the follow-up. One patient developed skin injury. CONCLUSION High intensity focused ultrasound is effective and safe in the treatment of malignant solid tumors.     

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.