摘要
目的:观察高强度聚焦超声治疗(high intensity focused ultrasound,HIFU)对晚期胰腺癌患者的疼痛程度、疼痛感觉及生存期的改善情况,评价其有效性和安全性。方法:回顾性分析2020年8月—2022年9月于上海中医药大学附属岳阳中西医结合医院肿瘤二科住院接受HIFU治疗的45例晚期胰腺癌伴有癌痛患者的临床资料。应用SPSS 26.0软件对HIFU治疗前后患者的NRS(numeric rating scale)疼痛评分表和BPI(brief pain inventory,BPI)疼痛评估量表进行统计学分析。使用Kaplan-Meier法计算中位总生存(overall survival,OS)期,绘制生存曲线。同时统计HIFU治疗过程中和治疗后相关不良反应发生率。结果:(1)45例患者中有30例患者接受HIFU联合化疗,其余15例患者仅接受HIFU治疗。(2)45例患者中有32例患者经HIFU治疗后疼痛得到缓解,HIFU治疗后1周、2周、3周、1个月时NRS评分持续下降,差异有统计学意义(P<0.05);BPI量表疼痛感觉评分也有相应下降,差异有统计学意义(P<0.05)。(3)45例患者的中位OS期为11.1个月(95%CI:9.30~12.90),其中30例接受HIFU联合化疗治疗的患者中位OS期为12.4个月(95%CI:9.18~15.62),15例仅接受HIFU治疗的患者中位OS期为4.6个月(95%CI:1.11~8.10)。(4)HIFU治疗过程中和治疗后所有患者均未出现严重并发症,仅有5例患者在治疗后出现了无症状的轻度血淀粉酶升高,轻度不良反应发生率为11.1%。结论:HIFU治疗晚期胰腺癌能够有效减轻患者疼痛,延长中位生存期,安全性较好。
Objective:To evaluate the efficacy and safety of ultrasound-guided high intensity focused ultrasound(HIFU)on pain intensity,pain sensation and overall survival in patients with advanced pancreatic cancer.Methods:Clinical data of advanced pancreatic cancer patients treated by HIFU were collected from the patients enrolled during August 2020 to September 2022 at the second department for oncology of Yueyang Hospital of Integrated Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine.In this study,SPSS 26.0 software was used for the statistical analysis of NRS score and BPI score.The Kaplan-Meier survival analysis method was applied to calculate the median overall survival(OS)and then the survival curve was drawn.At the same time,the incidence of related adverse reactions during and after HIFU treatment was counted.Results:(1)Among the 45 patients,30 patients received HIFU combined with chemotherapy,and the other 15 patients only received HIFU.(2)Among the 45 patients,32 patients had pain relief after HIFU treatment,and the NRS score kept decreased across 1 week,2 weeks,3 weeks and 1 month after HIFU treatment(P<0.05).The pain sensation score of BPI scale also decreased correspondingly,and the difference was statistically significant(P<0.05).(3)The median OS of 45 patients was 11.1 months(95%CI:9.30-12.90),of which 30 patients treated with HIFU combined chemotherapy had a median OS of 12.4 months(95%CI:9.18-15.62),and 15 patients treated with HIFU only had a median OS of 4.6 months(95%CI:1.11-8.10).(4)No serious adverse events were observed in all patients during and after HIFU treatment.Only 5 patients had asymptomatic mild elevation of blood amylase,and the incidence of mild adverse reactions was 11.1%.Conclusion:HIFU can effectively relieve pain and prolong the median survival time in patients with advanced pancreatic cancer.
作者
谢国群
胡正军
周小翠
郭晓冬
王静霞
李浏博
许秋琳
XIE Guoqun;HU Zhengjun;ZHOU Xiaocui;GUO Xiaodong;WANG Jingxia;LI Liubo;XU Qiulin(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shanghai Jiading Hospital of Traditional Chinese Medicine,Shanghai 201800,China)
出处
《肿瘤》
CAS
北大核心
2023年第10期799-808,共10页
Tumor
基金
上海中医药大学附属岳阳中西医结合医院中医专科建设项目:中医特色的肿瘤微创治疗专科(YWC-ZK2020-003)
关键词
高强度聚焦超声治疗
晚期胰腺癌
癌痛
生存效益
High intensity focused ultrasound
Advanced pancreatic cancer
Pain management
Survival benefit
作者简介
Correspondence to:郭晓冬,E-mail:gxd_1996@hotmail.com
