摘要
目的探讨高强度聚焦超声热疗(HIFU)联合中药消积止痛散治疗胰腺癌的疗效和安全性。方法61例胰腺癌患者随机分成观察组和对照组,观察组31例接受3～12次(平均6次)HIFU治疗,同时服用中药消积止痛散,对照组30例接受健择化疗。结果观察组CR3例,PR9例,PD3例,有效率38.7%,进展率9.7%;对照组CR1例,PR6例,PD14例,有效率23.3%,进展率46.7%;两组有效率比较无显著差异(P>0.05),进展率比较有显著差异(P<0.01)。观察组临床受益率67.7%,对照组36.7%,有显著差异(P<0.05)。两组均能下调CA199、CEA水平,治疗后与治疗前比较差异显著(P<0.05);治疗后两组CEA比较无显著差异(P>0.05),而观察组CA199较对照组下降明显,差异有显著性(P<0.01)。观察组中位生存期(15.6±11.7)个月较对照组(8.3±7.0)个月明显延长,有显著差异(P<0.01)。观察组3个月、6个月、1年、2年、3年生存率分别为93.5%、77.4%、51.6%、38.7%、3.2%;对照组分别为83.3%、56.7%、26.7%、6.7%、0%,其中1年、2年生存率观察组明显优于对照组,差异有显著性(P<0.05)。观察组治疗过程顺利,治疗后无皮肤灼伤、胃肠道穿孔、胰瘘及大出血等并发症,无Ⅱ级以上血液学毒性反应发生。结论高强度聚焦超声热疗联合中药消积止痛散能控制肿瘤进展、改善生活质量,延长生存期、对肿瘤标志CA199、CEA有下调作用,无明显毒副反应。
Objective To investigate the effect and safety of the combination of high intensity focused ultrasound （HIFU） and Xiao Ji Zhi Tong San in treating pancreatic carcinoma. Methods Sixty-one patients suffering from pancreatic carcinoma were divided into observation group and control group randomly. The 31 patients received 3-12 times （6 times in average） HIFU treatment while taking Xiao Ji Zhi Tong San continually in observation group. The other 30 patients received chemotherapy of gemzar. Results In observation group, 3 samples were complete remission, 9 samples part remission, 3 samples damage progressively. The overall response rate was 38.7%. In control group, 1 sample was complete remission, 6 samples were part remission, 14 samples damage progressively. The overall response rate was 23.3%. The overall response rate of two groups had no significant difference （P〉0.05）. However, the progressive damage rate had significant difference （P〈 0.01）. The benefit rate was 67.7% in the observation group while 36.7% in the control group. CA199 and CEA levels were all reduced in the two groups, the variability was significant before and after the treatment （P〈0.05）. It had no significant variability in CEA level of the two groups after treatment （P〉0.05）. However, CA199 level of observation group was reduced significantly compared with control group. The median survival time was （15.6 ±11.7） months in the observation group while it was （8.3±7.0） months in the control group. The survival rate in the observation group was 93.5 %, 77.4 M, 51.6%, 38.7%,3.2% at the following time： 3 months, 6 months, 1 year, 2 years and 3 years. The corresponding data were 83.3% ,56.7% ,26.7% ,6.7% ,and 0% in the control group. There was significant variability in the survival rate at 1 year and 2 years （P〈0.05）. The treatment course was well-off in the observation group. The complicated symptoms such as skin burn, gastric perforation, pancreatic fistula and massive hemorrhage did not perform after the treatment. Also no over Ⅱ hematologic toxicity occurred after the treatment. Conclusion The combination of HIFU and Xiao Ji Zhi Tong San in treating pancreatic carcinoma can control the progress of tumor, improve the quality of life, and prolong overall survival. It also can reduce CA199 and CEA levels. Furthermore, no significant toxicity occurred in the treatment.
出处
《中国医学影像技术》
CSCD
北大核心
2006年第8期1223-1226,共4页
Chinese Journal of Medical Imaging Technology
基金
江苏省中医药管理局基金资助项目(苏卫中医科[2001]19号H064)。
关键词
高强度聚焦超声热疗
消积止痛散
胰腺肿瘤
毒性
High intensity focused ultrasound
Xiao Ji Zhi Tong San
Pancreatic neoplasms
Toxicity
