高强度聚焦超声联合全身化疗对结直肠癌肝转移近期疗效.docVIP

高强度聚焦超声联合全身化疗对结直肠癌肝转移近期疗效 　　[摘要] 目的 观察高强度聚焦超声（以下简称HIFU）联合全身化疗治疗结直肠癌肝转移的近期疗效。 方法 选取结直肠癌肝转移患者103例，随机分为HIFU联合化疗组和常规化疗组。结果 联合化疗组近期有效率为74.0%，常规化疗组近期有效率为54.7%，两组比较有显著性差异（P 　　[关键词] 结直肠癌；肝转移；高强度聚焦超声；化疗 　　[中图分类号] R735.3 [文献标识码] B [文章编号] 1673-9701（2013）32-0154-03 　　The recent curative efficacy of therapy of high intensity focused ultrasound combined with systemic chemotherapy treatment on liver metastasis of colorectal cancer 　　ZHANG Weixing ZHONG Yu PENG Biling HUANG Yao DENG Weiping 　　Department of General Surgery， Shenzhen Futian People’s Hospital， Guangdong Province， Shenzhen 518033， China 　　[Abstract] Objective To observe the recent curative efficacy of therapy of high intensity focused ultrasound （HIFU） combined with Systemic chemotherapy treatment on liver metastasis of colorectal cancer. Methods A total of 103 patients with liver metastasis of colorectal cancer were divided into two groups randomly. Combined chemotherapy group of patients received HIFU combined with systemic chemotherapy and conventional chemotherapy group received systemic chemotherapy only. Results Combined chemotherapy groups recent effective rate was 74.0% and conventional chemotherapy group was 54.7%. The difference between two groups had significant difference （P0.05），见表1。 　　1.2 方法 　　常规化疗组采用化疗方案为FOLFOX-6、CapeOX或FOLFIRI。联合化疗组在征得患者同意并填写知情同意书后，在常规化疗的同时对肝转移癌进行高强度聚焦超声治疗。采用重庆海扶技术有限公司生产的JC型高强度聚焦超声肿瘤治疗系统对肝转移癌进行高强度聚焦超声治疗，治疗范围为完全覆盖，平均治疗时间为300 s/cm3。平均治疗功率为300～400 W。 　　1.3 近期疗效的评价 　　①以RECIST评价标准（MRI或CT影像学作为测量手段）评价两组每2个治疗周期后疗效（CR：所有目标病灶消失；PR：基线病灶长径总和缩小≥30%；SD：基线病灶长径总和有缩小但未达PR或有增加但未达PD；PD：基线病灶长径总和增加≥20%或出现新病灶），6个周期结束治疗，如未达6个治???周期出现疾病进展或复发（PD）则结束原治疗方案并详细记录肿瘤客观进展情况。治疗效果以首次评价至少4周后复核确认。②按WHO急性和亚急性毒副反应的表现和分度标准（0～Ⅳ度）评价不良反应。 　　1.4统计学处理 　　使用SPSS 19.0统计软件进行统计分析，计数资料采用χ2检验，计量资料采用t检验，P 　　[2] Haraldsdottir S，Wu C，Bloomston M，et al. What is the optimal neo-adjuvant treatment for liver metastasis[J]. Ther Adv Med Oncol，2013，5（4）：221-234. 　　[3] Cheung TT，Fan ST，Chu FS，et al. Survival analysis of high-inten