高强度聚焦超声治疗结直肠癌肝转移的临床疗效评价和预后影响因素
发布时间：2018-07-26 15:26
【摘要】：目的:高强度聚焦超声(H IFU)作为兴起不久的一种非侵入性治疗技术,虽已投入多种实体肿瘤的治疗且也取得一定疗效,但很多医生和患者对该治疗方式的认识仍很局限,我们希望通过分析结直肠癌肝转移患者接受治疗的情况,探讨其在治疗结直肠癌肝转移中的安全性和有效性以及影响其预后的因素,从而探究其在治疗结直肠癌肝转移领域是否具有临床价值和是否值得被推广。资料和方法:回顾性分析2001年3月至2012年12月在重庆医科大学附属第二医院HIFU肿瘤中心接受HIFU消融治疗的39例结直肠癌肝转移患者术前术后肝功、CEA和影像学检查(CT或MRI)的变化情况,生存结果,以COX比例风险回归模型确定影响预后的独立因素。结果:1.39例结直肠癌肝转移患者接受HIFU消融治疗后ALT升高(P0.05),白蛋白下降(P0.05),总胆红素变化不大(P0.05)。2.39例结直肠癌肝转移患者接受HIFU消融治疗后CEA值较术前降低(P0.05)。3.39例结直肠癌肝转移患者接受HIFU消融治疗后复查增强CT或MRI示:完全消融16例(41.0%),部分消融19例(48.7%),未消融4例(10.3%)。4.39例结直肠癌肝转移患者(失访3人)接受HIFU消融治疗后的中位生存期为25个月,1、2、3、5年生存率为91.7%、55.6%、22.2%、5.6%。5.性别、年龄、原发肿瘤部位、是否有肝外转移、病灶数目以及病灶消融范围对预后影响均不显著(P0.05)。结论:1.对于不能手术切除或不愿行手术切除的结直肠癌肝转移患者,高强度聚焦超声(HIFU)是一种可选择的安全且有效的治疗方式。2.虽然在此研究中,性别、年龄、原发肿瘤部位、有无肝外转移、病灶数目以及病灶消融范围均对患者预后无影响,但其还需行进一步的前瞻的研究。
[Abstract]:Objective: high intensity focused ultrasound (HIFU) (H IFU) is a new non-invasive treatment technique. Although it has been used in the treatment of various solid tumors and has achieved certain curative effect, many doctors and patients still have very limited understanding of the treatment method. We hope to investigate the safety and efficacy of the treatment of colorectal cancer with liver metastasis and the prognostic factors by analyzing the status of treatment of patients with liver metastasis from colorectal cancer. To explore whether it has clinical value and whether it is worth popularizing in the field of liver metastasis of colorectal cancer. Materials and methods: from March 2001 to December 2012, 39 patients with liver metastases from colorectal cancer receiving HIFU ablation at HIFU tumor Center, second affiliated Hospital of Chongqing Medical University, were retrospectively analyzed. Changes in (CT or MRI), COX proportional risk regression model was used to determine the independent prognostic factors. Results after HIFU ablation, ALT increased (P0.05), albumin decreased (P0.05), and total bilirubin did not change significantly in 1.39 patients with liver metastasis of colorectal cancer after HIFU ablation (P0.05). After HIFU ablation, CT or MRI showed that 16 cases (41.0%) were completely ablated, 19 cases (48.7%) were partially ablated, and 4 cases (10.3%) were not ablated. 4.39 cases of liver metastasis from colorectal cancer (3 missing persons) received HIFU ablation. The survival time was 25 months and the 5-year survival rate was 91.7 and 55.6 respectively. Sex, age, primary tumor location, whether there were extrahepatic metastasis, the number of lesions and the extent of ablation had no significant effect on the prognosis (P0.05). Conclusion 1. High intensity focused ultrasound (HIFU) is an alternative safe and effective treatment for patients with liver metastases from colorectal cancer who are not surgically resected or unwilling to undergo surgical resection. Although sex, age, primary tumor location, extrahepatic metastasis, the number of lesions and the extent of ablation have no effect on the prognosis of the patients, further prospective studies are needed.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.34
本文编号：2146448
[Abstract]:Objective: high intensity focused ultrasound (HIFU) (H IFU) is a new non-invasive treatment technique. Although it has been used in the treatment of various solid tumors and has achieved certain curative effect, many doctors and patients still have very limited understanding of the treatment method. We hope to investigate the safety and efficacy of the treatment of colorectal cancer with liver metastasis and the prognostic factors by analyzing the status of treatment of patients with liver metastasis from colorectal cancer. To explore whether it has clinical value and whether it is worth popularizing in the field of liver metastasis of colorectal cancer. Materials and methods: from March 2001 to December 2012, 39 patients with liver metastases from colorectal cancer receiving HIFU ablation at HIFU tumor Center, second affiliated Hospital of Chongqing Medical University, were retrospectively analyzed. Changes in (CT or MRI), COX proportional risk regression model was used to determine the independent prognostic factors. Results after HIFU ablation, ALT increased (P0.05), albumin decreased (P0.05), and total bilirubin did not change significantly in 1.39 patients with liver metastasis of colorectal cancer after HIFU ablation (P0.05). After HIFU ablation, CT or MRI showed that 16 cases (41.0%) were completely ablated, 19 cases (48.7%) were partially ablated, and 4 cases (10.3%) were not ablated. 4.39 cases of liver metastasis from colorectal cancer (3 missing persons) received HIFU ablation. The survival time was 25 months and the 5-year survival rate was 91.7 and 55.6 respectively. Sex, age, primary tumor location, whether there were extrahepatic metastasis, the number of lesions and the extent of ablation had no significant effect on the prognosis (P0.05). Conclusion 1. High intensity focused ultrasound (HIFU) is an alternative safe and effective treatment for patients with liver metastases from colorectal cancer who are not surgically resected or unwilling to undergo surgical resection. Although sex, age, primary tumor location, extrahepatic metastasis, the number of lesions and the extent of ablation have no effect on the prognosis of the patients, further prospective studies are needed.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.34
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