%0 Journal Article %T 高强度聚焦超声治疗非手术胰腺癌近期疗效评价及生存分析 %A 余怡 %A 许青 %A 朱忠政 %A 茅伟 %A 李莉 %A 李青 %J 同济大学学报(医学版) %D 2018 %R 10.16118/j.1008-0392.2018.04.012 %X 目的 探讨高强度聚焦超声(high intensity focused ultrasound, HIFU)治疗非手术胰腺癌近期疗效及生存情况。方法 筛选符合入组条件的非手术胰腺癌患者30例(3例患者共接受2次HIFU治疗,共计33例次),记录患者HIFU治疗前1周和治疗后1个月肿瘤标志物CA19-9和靶病灶影像学变化,对患者进行生存随访。结果 HIFU治疗后,靶病灶最大直径为(4.8±1.54)cm,与治疗前最大直径(4.67±1.50)cm相比,差异无统计学意义(P=0.328);胰腺超声造影检查提示靶病灶区血供减少,CT增强检查示靶病灶区内密度降低,MRI增强检查示T1WI信号增加,T2WI信号降低;57.7%患者血清CA19-9降低。30例患者中位生存期10.4个月(95%CI: 7.93~12.8),6、12个月生存率分别为66.7%和20%。结论 HIFU治疗能够有效抑制肿瘤生长,减轻肿瘤负荷,延长胰腺癌患者的生存期,且不良反应少,是非手术胰腺癌患者的治疗方法之一。</br>Objective To evaluate the short-term efficacy and survival of patients with pancreatic cancer undergoing high-intensity focused ultrasound (HIFU). Methods Thirty patients with inoperable pancreatic cancer underwent 33 treatments of HIFU. The serum level of CA19-9, imaging findings and complications were recorded 1 month after HIFU treatment. The median survival time(MST)was calculated by Kaplan-Meier method. Results The maximum size of tumor was not significantly changed after HIFU treatment [before treatment (4.8±1.54) cm, after treatment (4.67±1.50) cm, P=0.472]. Imaging examination suggested that coagulation necrosis occurred in the target lesion and the blood supply was reduced or disappeared in the enhanced images; serum CA19-9 levels were decreased in 57.7% patients. The medium survival time (MST) was 10.4 months(95%CI: 7.93-12.8); 6-month and 1-year survival rates were 66.7% and 20% respectively. Conclusion HIFU may benefit to advanced pancreatic cancer patient by stabilizing tumors, alleviating tumor burden and prolonging survival with less complications, which can be chosen as a palliative treatment in patients with inoperable pancreatic cancer %K 胰腺癌 高强度聚焦超声 生存分析< %K /br> %K pancreatic cancer high-intensity focused ultrasound survival analysis %U http://tjyxxb.cnjournals.cn/ch/reader/view_abstract.aspx?file_no=20180412&flag=1