PFC方案化疗联合高强度聚焦超声治疗进展期胃癌的临床观察

目的:评价PFC方案化疗联合高强度聚焦超声(HIFU)治疗进展期胃癌的疗效和不良反应。方法:经病理学确诊的进展期胃癌患者60例,分A、B两组,每组30例。A组予PFC方案(紫杉醇+氟尿嘧啶+顺铂)化疗的同时行病灶部位HIFU治疗;B组单用PFC方案化疗。结果:60例均可评价疗效,A组CR5例(16.7%),PR17例(56.7%),SD4例(13.3%),PD4例(13.3%),有效率(CR+PR)73.3%,中位生存期13.9月;B组CR2例(6.7%),PR14例(46.7%),SD7例(23.3%),PD7例(23.3%),有效率53.3%,中位生存期9.6月。二组有效率无显著性差异(P>0.05),中位生存期差异有显著性(P<0.05)。主要不良反应为骨髓抑制、恶心、呕吐和脱发,二组无显著性差异(P>0.05)。结论:PFC方案化疗结合HIFU治疗进展期胃癌为一种新的疗法,其近期疗效确切,不良反应轻,患者能耐受,且能明显改善患者的中位生存期,延长患者生命,对于进展期胃癌患者如能在化疗的同时联合HIFU治疗则不失为有效治疗手段,值得深入探讨。

High intensity focused ultrasound in combination with chemotherapy by the regime of PFC:A clinical study for treating patients with advanced gastric carcinoma

Objective:To evaluate the recent curative efficacy and security of high intensity focused ultrasound (HIFU) in combination with chemotherapy (PFC) in patients with advanced gastric carcinoma.Methods:60 patients with measurable advanced gastric carcinoma,proved pathologically,were divided into A and B group.Group A:Patients were treated by HIFU(FEP-BY01) in combination with chemotherapy(PFC,paclitaxel,cisplatin and 5-fluorouracil).Group B:Patients were treated with the single regime of PFC.Results:All cases could be evaluated. In group A,5 patients achieved complete response,and 17 patients achieved partial response,for a response rate of 73.3%.The stable disease(SD) was 13.3%(4/30).The inefficiency was 13.3%(4/30).Median survival time (MST) was 13.9 months.In group B,2 patients achieved complete response,and 14 patients achieved partial response,for a response rate of 53.3%.The stable disease(SD) was 23.3%(7/30).The inefficiency was 23.3%(7/30).Median survival time was 9.6 months.Significant differences between two groups were in the MST(P<0.05),while there was P=0.108 in the RR.Major toxicities included bone marrow depression,nausea,vomiting and alopecia,without significant differences between them(P>0.05).Conclusion:This study shows that HIFU in combination with chemotherapy(PFC) was a new efficacious secure therapy for the patients with advanced gastric carcinoma.It was observed that the MST was prolonged.Prospective trials should be warranted to determine the result.