高强度聚焦超声治疗老年原发性肝癌的有效性及安全性临床观察

目的 评价高强度聚焦超声(HIFU)在老年原发性肝癌患者的有效性及安全性.方法 纳入2014年1月-2016年12月期间在复旦大学附属华东医院肿瘤微创治疗部接受HIFU治疗的CNLC分期为Ⅱa期以内的老年原发性肝癌患者41例.回顾分析所有患者的临床资料、治疗疗效及不良反应,并随访患者的总体生存率(OS).疗效根据1.1...

Clinical observation on the efficacy and safety of high-intensity focused ultrasound in the treatment of primary liver cancer in the elderly

Objective To evaluate the efficacy and safety of high-intensity focused ultrasound(HIFU)in the treatment of primary liver cancer(PLC)in the elderly.Methods 41 elderly patients with PLC with CNLC stage less thanⅡa who received HIFU treatment in Department of Tumor Minimally Invasive Treatment,Huadong Hospital Affiliated to Fudan University from January 2014 to December 2016 were included.The clinical data,therapeutic efficacy and adverse reactions of all patients were retrospectively analyzed,and the overall survival rate(OS)was followed up.Efficacy was evaluated according to the Response Evaluation Criteria in Solid Tumors(RECIST)v 1.1,and adverse reactions were evaluated according to the Common Terminology Criteria for Adverse Events v 4.0(CTCAE 4.0).Results After HIFU treatment,2 cases(4.9%)were complete remission,29 cases(70.7%)were partial remission,8 cases(19.5%)were stable,and 2 cases(4.9%)were progress.During the 24-month follow-up period,the patient’s median survival time was 23 months;the 1-year and 2-year survival rates were 87.8%and 42.7%,respectively.Multivariate analysis showed that ECOG score 1(HR=3.71;95%CI=1.11-12.48;P=0.33)and multiple lesions(HR=14.36;95%CI=1.69-46.26;P=0.015)were independent risk factors for the prognosis of elderly PLC patients who received HIFU treatment.There were no adverse events≥grade 3.During HIFU treatment,a small number of patients(n=9,22.0%)had skin redness,which could heal spontaneously;1 patient had fever;1 patient had mild chest wall pain,which was treated with non-steroidal analgesia and stopped after 3 days;most patients had mild to moderate pain,and the pain relieves spontaneously after treatment was stopped.No skin burns,gastrointestinal perforation,bleeding and other adverse reactions were observed.Conclusion As a non-invasive treatment,HIFU can effectively control the growth of PLC,relieve pain,prolong the survival time of patients,without obvious adverse reactions.It is one of the safe and effective treatment options for elderly patients with PLC.