Extracorporeal high intensity focused ultrasound ablation in the treatment of patients with large hepatocellular carcinoma
Extracorporeal high intensity focused ultrasound ablation in the treatment of patients with large hepatocellular carcinoma
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DOI：
10.1245/aso.2004.02.026
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发表时间：
2004-12-01
影响因子：
3.7
通讯作者：
Su, HB
中科院分区：
文献类型：
--
作者：
Feng, W;Wang, ZB;Su, HB
背景：高强度聚焦超声（HIFU）是一种无创治疗方式，可通过完整皮肤诱导深层肿瘤完全凝固性坏死。目前的研究旨在确定体外 HIFU 治疗肝细胞癌 (HCC) 患者的安全性、有效性和可行性。方法：共有 55 名肝硬化 HCC 患者参加了这项前瞻性、非随机临床试验。其中，51名患者患有无法切除的HCC。肿瘤直径为4至14厘米，平均直径为8.14厘米。根据肿瘤、淋巴结、转移（TNM）分类，15名患者对应于11期，16名患者对应于IIIA期，24名患者对应于IIIC期。所有患者均接受了 HIFU，中位 HIFU 次数为 1.69 次。本试验评估了 HIFU 的安全性和有效性。结果：接受 HIFU 治疗的患者未观察到严重的副作用。后续影像显示肿瘤血管供应缺失且治疗病灶缩小。 34%的患者血清甲胎蛋白恢复到正常水平。 6、12和18个月的总生存率分别为86.1%、61.5%和35.3%。 II期患者的生存率显着高于IIIA期（P = .0132）和IIIC期（P = .0265）。结论：作为一种无创治疗，HIFU在HCC患者的治疗中似乎是有效、安全和可行的。它可能在大肿瘤的消融中发挥重要作用。
Background: High intensity focused ultrasound (HIFU) is a noninvasive treatment modality that induces complete coagulative necrosis of a deep tumor through the intact skin. The current study was conducted to determine the safety, efficacy, and feasibility of extracorporeal HIFU in the treatment of patients with hepatocellular carcinoma (HCC).Methods: A total of 55 patients with HCC with cirrhosis were enrolled in this prospective, nonrandomized clinical trial. Among them, 51 patients had unresectable HCC. Tumor size ranged from 4 to 14 cm in diameter with mean diameter of 8.14 cm. According to tumor, node, metastasis (TNM) classification, 15 patients corresponded to stage 11, 16 to stage IIIA, and 24 to IIIC. All patients had HIFU, and the median number of HIFU session was 1.69. Safety and efficacy of HIFU were assessed in this trial.Results: No severe side effect was observed in the patients treated with HIFU. Follow-up imaging showed an absence of tumor vascular supply and the shrinkage of treated lesions. Serum a-fetoprotein returned to normal level in 34% of patients. The overall survival rates at 6, 12, and 18 months were 86.1%, 61.5%, and 35.3%, respectively. The survival rates were significantly higher in patients in stage II than those in stage IIIA (P =.0132) and in stage IIIC (P =.0265).Conclusion: As a noninvasive therapy, HIFU appears to be effective, safe, and feasible in the treatment of patients with HCC. It may play an important role in the ablation of large tumors.