GEMOX方案联合高强度超声聚焦治疗晚期胰腺癌23例临床观察

目的:探讨高强度超声聚焦（HIFU）联合GEMOX方案治疗晚期胰腺癌的疗效和安全性。方法:23例经病理证实的转移性胰腺癌患者，予GEMOX方案（奥沙利铂135mg/m2,静脉滴注，d1，吉西他滨1.0g/m2,静脉滴注，d1,8）化疗，21天为1个周期。同时应用FEP-BY02型高能聚焦超声肿瘤治疗机治疗，根据肿瘤大小、转移数目、部位决定治疗次数，每次治疗时间约30-50分钟，每次间隔1-2天。治疗后定期随访观察0.6-2年。通过治疗有效率、疾病控制率、CA199水平的变化及不良反应进行评价，并分析生存状况。结果:23例患者接受治疗，全部可评价疗效，治疗有效率（RR）17.39%，疾病控制率（DCR）56.52%，中位无疾病进展生存时间（mTTP）3.3个月，中位总生存时间（mOS）7.9个月，1年生存率8.69%。12例患者CA199出现下降。总获益率(CBR)43.48%。Ⅲ级以上不良反应共5例（21.74%）。最常见的不良反应为疲乏，共15例。结论:对于晚期胰腺癌患者，GEMOX方案联合高强度超声聚焦是一种有效的治疗手段，不良反应可以耐受，值得扩大样本量进一步研究。

The clinical observation of 23 cases with advanced pancreatic cancer treated with GE- MOX combined with high intensity focused ultrasound

Objective：To investigate the effect and safety of high - intensity focused ultrasound （HIFU） combined with GEMOX treatment for patients with the advanced pancreatic cancer. Methods：Twenty three patients with the pathologically confirmed metastatic pancreatic cancer were treated with GEMOX （oxaliplatin 135mg/m2 ivgtt d, , gem- citabine 1.0g/m2 ivgtt dl.s ）, a chemotherapy cycle was 21 days. The number of FEP - BY02 - type high - intensity focused ultrasound treatment were determined by the tumor size, number of metastatic tumors, and the tumor location. Each treatment takes about 30 to 50 minutes with an interval of 1 to 2 days. After treatment, regular follow - up obser- vations were carried out within 0.6 to 2 years. The treatment effect was evaluated and survival situation was analyzed according to the efficiency, disease control rate, change in CA199 levels, and the adverse reactions. Results：All 23 pa- tients were evaluable for the treatment effect. The treatment efficiency（RR） was 17.39%, disease control rate（DCR） was 56.52%, the median progression- free survival time（mTTP） was 3.3 months, median overall survival time （mOS） was 7.9 months,and one year survival rate was 8.69%. CA199 of 12 patients decreased. The total clinical benefit rate（CBR） was 43.48%. There were 5 cases of adverse reactions higher than level m （21.74%）. The most common adverse reaction was fatigue, with 15 cases. Conclusion：For patients with advanced pancreatic cancer, GE- MOX regimen combined with high - intensity focused ultrasound is an effective treatment with tolerable adverse reac- tions.