Zhou Dinghua, Lv Wei, the kingdom of Wei Baodong, 000, ice, Zhang Jianhua, Chen Sheng, Zhang JianguoDepartment of hepatobiliary and gastroin
Zhou Dinghua, Lv Wei, the kingdom of Wei Baodong, 000, ice, Zhang Jianhua, Chen Sheng, Zhang Jianguo
Department of hepatobiliary and gastrointestinal diseases, PLA General Hospital, Second Artillery General Hospital, Beijing,, China
Abstract: Objective To observe the efficacy and safety of high intensity focused ultrasound (HIFU) in the treatment of abdominal solid tumors. Methods 92 patients with abdominal solid tumors were treated with RJC200 high intensity focused ultrasound (HIFU). Results in 11 cases (PR), SD () was found in 50 cases () in all of the patients (= 33.7). There were no CR cases in the whole group, RR = 11.4, DCR = PD. After treatment, 82.9% of patients with pain symptoms were significantly relieved, of which mild skin burns occurred in all cases, and all of the patients had no complications such as pancreatic leakage, bleeding, gastrointestinal perforation, and so on in 1 cases. Conclusion HIFU is a safe and effective method for the treatment of abdominal solid tumors.
Key words: abdominal solid tumor; high intensity focused ultrasound
Clinical Investigation of Intensity Ultrasound for Treatment of Patients Solid with Tumor in the Abdomen the Focused High
Zhou Ding-Hua, Lv Wei, Wang Guo-Jing, et al. (Center of and Gastrointestinal Disease, Chinese PLA Artillery General Hospital, Beijing 100088, China), Hepatobiliary (Second)
[Abstract] Objective To investigate the effect and safety of high intensity focused ultrasound (HIFU) for the treatment of patients with Abdominal Solid Tumor. Methods Ninety two patients with Abdominal Solid Tumor were treated by HIFU, and its efficacy and safety were investigated. Results in all 35patients attained PR 11 (11.6%), 50 (54.5%), patients attained SD and the overall response rate (CR+PR) was 11.4%. Easement of pain was attained in 76 of 92 (82.9%) patients with lumbago and bellyache. No complications (i.e. sever Shin burn, pancreatic leakage, bleeding gastrointestinal, perforation occurred all patients. Conclusion) in HIFU is an effective and safe way for the treatment of Abdominal Solid Tumor.
[Key words] Abdominal, Solid Tumor, HIFU
High intensity focused ultrasound (HIFU) as a new means of cancer treatment makes some frail lose lose the chance of operation, radiotherapy and chemotherapy of tumor patients provides opportunity treatment possible and got satisfactory clinical effect. Our hospital in July 2009 -2010 in the application of the technology in the treatment of cases of primary or secondary abdominal solid tumor patients, achieved good results, are reported as follows: 92.
1 materials and methods
1.1 general data of patients admitted to our hospital from July 2009 to January 2010 were treated with abdominal solid tumors in 92 cases, male in 58 cases, female in 34 cases, aged from 28 to 71 years, median age of 51 years old. All cases were confirmed by pathology, including 51 cases of primary liver cancer, 29 cases of pancreatic carcinoma, lymph node metastasis (12 cases of retroperitoneal primary diseases were: 5 cases of colorectal cancer, 4 cases of gastric cancer, 3 cases of bile duct carcinoma, 3 cases of gastrointestinal stromal tumors); all cases were accompanied by abdominal or back pain; all cases were by B ultrasound examination showed the lesions, lesions of the minimum diameter of 2.5 cm, a maximum of 12.5 cm, the average (6.8 + 1.1) cm, Karnofsky score more than 60 points in all cases, expected survival time more than 3 months; normal ECG, no bleeding tendency.
1.2 JC200 high intensity focused ultrasound tumor treatment system developed by Chongqing Hai Fu medical equipment Co., Ltd. HIFU. The system uses ultrasonic positioning, ultrasonic frequency 1MHz + 10, the input power is 0.5 ~ 2kW, the focal intensity as 900~4000 W/cm, 1~15 cm the effective treatment depth, the treatment medium was degassed tap water, the launch time unit (T1) in 0.1~0.2 S. Space time (T2) t2:tl = 1:1~2:1, the number of each point (N) from 30 to 80. The measured focus is 3mm * 3mm * 8mm. Before and after treatment, the follow-up examination was performed with TOSHIBA-240 type ultrasonic diagnostic apparatus and spiral CT.
1.3 treatment methods according to the general situation of the patients, the location, size, shape, and the relationship with adjacent organs were determined by b-ultrasound. The treatment plan includes the scope of treatment, the number of treatment levels, the level of each area and treatment points. Finally, under the automatic control of the computer, from deep to shallow, each level of the target area is treated until the whole predetermined therapeutic target area is covered.
1.3.1 treatment of patients with supine position, intravenous anesthesia, the positioning of the airborne B ultrasound probe to determine the scope, size and level of treatment.
According to the location, size, shape and adjacent relationship of the lesions detected by 1.3.2 scan, the range of HIFU treatment was determined.
1.3.3 patients were treated 1 times a day or the next day for a total of 1 times, and a total of 92 patients received a total of 368 HIFU
1 times, up to 12 times.
1.4 evaluation criteria and follow-up
1.4.1 evaluation of short-term efficacy according to WHO standard , respectively, complete remission (CR), partial remission (PR), stable (SD) and progression (PD), with CR+PR as effective (RR), CR+PR+SD for Disease Control (DCR).
1.4.2 pain relief evaluation before and after treatment for patients with local pain symptoms using VAS pain score score. Patients were selected 0 ~ 10 of the figures in order to develop the degree of pain, that is, no pain, 1~3 for mild pain, 4~6 for moderate pain, 7~10 for severe pain. Evaluation of pain relief: 0 degrees, 1 degrees, no remission; mild remission (pain about 1/4); 2, moderate relief (pain about 1/2); 3 degrees, relieve (pain above 3/4); 4, complete remission (pain).
All patients were followed up for more than 2 months after 1.4.3.
1.5 quality of life score according to Karnofsky (KPS) score. No symptoms and signs (100); to carry on normal activity, mild symptoms and signs (90); barely normal activities, with symptoms and signs (80); life can take care of themselves, can not maintain the normal life and work (70); sometimes people need help, but most of the time you can take care of (60); often take care of people (50), life can not take care of themselves, need special care (40); serious life can not take care of themselves (30); ill, hospitalized supportive care (20).
1.6 statistical methods using SPSS 10 statistical analysis software, using t test or rank sum test.
2.1 local efficacy of the total of 92 patients were treated for a total of, with an average of 4 cases, including PR in 11 cases (11.6%), SD in 50 cases (54.5), PD in 31 cases (33.7), no CR cases in the whole group, RR l1.4, DCR.
2.2 pain relief in 92 cases of selection of patients with abdominal or back pain, pain score before treatment was 7 + 2.1; after treatment, all patients in the analgesic measures unchanged, pain score decreased to 4.1 + 1 (high temperature, P50 degrees by thermal effect and cavitation effect and mechanical effect etc. the role of the physical organization or solidification, degeneration and necrosis of tumor tissue, thereby achieving the purpose of treatment of . Related basic research has confirmed that it can cause other biological effects such as inducing apoptosis and up regulating cellular immune function, . Recent clinical studies show that  HIFU has been widely recognized as a local means in the local disease control tumor at the same time, can quickly relieve pain, improve the quality of life, and no obvious adverse reaction of [5,6,7].
Using the JC200 focused ultrasound tumor therapy system will abdominal multiple organ malignant tumor killing, caused by malignant tumor tissue degeneration and coagulation necrosis of advanced malignant tumors achieved good clinical efficacy. The 92 cases of patients with advanced malignant solid tumors, such patients can not tolerate surgery or refused surgery, or postoperative recurrence and postoperative residual, and has been difficult to tolerate the regular radiotherapy and chemotherapy. After the treatment of HIFU, it can kill the tumor load, improve the body condition, relieve the cancer pain and prolong the survival time of the tumor patients. In this group, 72 cases had different degrees of pain, and the pain was relieved after treatment in 95.8% cases. In this group of cases, 1 cases of I0 burn, no perforation, massive hemorrhage, peritonitis, pancreatic fistula, severe burns and other adverse reactions, showed good tolerability. It is the key to ensure the accuracy of the local treatment to reduce the adverse reaction by the accurate control of HIFU and the precise location of the target. For many patients, should pay attention to each treatment condition (step, interval) accuracy and the therapeutic range (treatment areas X, Y axis), to ensure the repeatability of the consistency of the treatment process and patient posture and ultrasound images of airborne targets, to ensure convergence, avoid target missing and over treatment.
As a candidate for the treatment of advanced tumors, HIFU has lost the chance of traditional therapy, and it has attracted more and more attention because of its non-invasive, no systemic toxic side effects, and exact therapeutic effect. HIFU is a cutting-edge technology for the treatment of tumors, and has achieved promising results in the treatment of certain cancers. However, HIFU as a non-invasive in vivo tumor deep technology, can not ensure the one-time complete resection of solid tumor lesions, which requires us to do in-depth research on ultrasonic positioning, resection, treatment, intraoperative HIFU, interventional HIFU may become an important means of abdominal tumor treatment. The absorption and reflection of ultrasonic complex and tissue interface, are related with the density of tissue blood vessels, how to reasonably use the appropriate dose so as to destroy the tumor, and can protect the normal tissue is the key to improve the therapeutic effect of HIFU. Although most studies suggest that HIFU does not contribute to metastasis, the relationship between HIFU and tumor metastasis, HIFU and immunity needs to be further studied. In addition, HIFU is a local treatment, how to cooperate with good radiotherapy and chemotherapy, how to arrange the order of treatment has yet to be explored.
The development of surgical technique is based on the evolutionary trajectory of giant invasive, invasive and minimally invasive, and the appearance of HIFU provides a real non-invasive treatment for clinicians. The application of HIFU is not only limited to the direct treatment of malignant tumors, but also can be used in the treatment of benign tumors and non neoplastic diseases such as malignant tumors, chronic pain, palliative treatment, surgical hemostasis, etc.. Recent technological developments and medical practice have shown that the application of HIFU in the future surgical field will play a pivotal role. We believe that with the development and application of HIFU technology, HIFU technology will better serve the cause of human health.
1 Patrick Therase, SuSan G.Arbuck, Elizabeth A, et al. guidelines evaluate response to in solid tumors. of the National Cancer Institute, 2000, 92 (3): 205-216 New (Journal) treatment the
2 Rove KO, Sullivan KF, Crawford ED focused ready primetime. Urol North Am. ultrasound:, 37 (1): 27-35..High-intensity (for), Clin
3 Williams AK, Mart Nez CH, Chalasani V, Chin J. High-intensity focused ultrasound: where are we and where to from here Expert Rev Anticancer? Ther. 2010, 10 (1): 33-40.
4 clinical application of high intensity focused ultrasound tumor therapy system (Trial). Chinese Journal of medicine, 85 (): 796-797 (L)
5 Li Linping, Yu Xiaomin. Quantitative analysis of HIFU documents in 1998~2006. Medical education exploration, 2008, (): 537-541 (in Chinese)
6 Dong Baowei, Zhang Wu. Application of high intensity focused ultrasound (HIFU). Chinese Journal of medical ultrasound. 2005,2 (1): 1-2
7 Wang Zhibiao. Basic research and clinical application of high intensity focused ultrasound (HIFU). Proceedings of the twenty-first Century Symposium on medical engineering.2001
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