ACRPO  >> Vol. 4 No. 1 (January 2015)

    Clinical Observation of High Intensity Focused Ultrasound (HIFU) Ablation Combined with Qingyihuaji Formula for SalvageTreatment for Advanced Pancreatic Cancer Patients Failed to Systemic Chemotherapy

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何胜利,沈 婕,胡南华,蔡芸芸,孙贤俊:复旦大学附属肿瘤医院闵行分院肝胆胰肿瘤中西医结合科,上海;

清胰化积方高强聚焦超声胰腺癌Qingyihuaji Formula High Intensity Focused Ultrasound (HIFU) Pancreatic Cancer


目的:研究高强度聚焦超声(HIFU)胰腺肿瘤局部消融联合清胰化积方治疗化疗失败的中晚期胰腺癌临床疗效观察。方法:采用HIFU联合清胰化积方治疗29例中晚期胰腺癌患者,其中发生肝、后腹膜淋巴结等部位转移23例,局部晚期6例。本研究主要观察联合治疗疗效、生存期、疼痛变化及并发症等情况。结果:29例患者均可进行近期疗效评估,部分缓解3例(10.3%),稳定7例(24.1%),进展19例(65.5%),有效率(RR)10.3% (3例),疾病控制率(DCR)为34.5%。中位无疾病进展时间(PFS)为2.8个月,中位总生存时间(OS)8.1个月。75%患者疼痛获得了不同程度的减轻。治疗后的KPS评分为78.5  6.4,高于治疗前64.5  4.2,差异有统计学意义(P < 0.05)。不良反应主要以1~2级消化道反应为主,未出现骨髓毒性、上消化道出血或胃肠穿孔等严重并发症。结论:HIFU联合中药治疗化疗失败的中晚期胰腺癌具有一定临床疗效、且毒副作用轻,值得临床进一步研究。

Objective: To evaluate the efficacy and toxicity of high intensity focused ultrasound (HIFU) for local ablation of pancreatic tumor combined with Qingyihuaji formula as the palliative treatment for advanced pancreatic cancer patients failed to systemic chemotherapy. Methods: 29 advanced pancreatic cancer patients who failed systemic chemotherapy accepted HIFU and Qingyihuaji formula treatment from January 2012 to December 2013. The occurrence of liver, retroperitoneal, and other parts of the metastasis in 23 cases, 6 cases of local advanced. The curative effects, the pain changes and toxicity were evaluated, and progression-free survival (PSF) and over survival (OS) were calculated from the date of follow-up. Results: All the 29 patients can receive the short-term efficacy evaluation. There were 3 cases of partial response (PR), 7 of stable disease (SD) and 19 of progressive disease (PR) with RR of 10.3% and DCR of 34.5%. The median PFS and OS were 2.5 and 8.1 months, respectively. 75% patients reported significant reductions in their pain levels. The KPS was 78.5  6.4 after combination treatment, higher than 64.5  4.2 before treatment. The major side effect was grade 1 - 2 gastrointestinal response. There were no marrow toxicities and serious complications such as gastrointestinal hemorrhage or perforation of gastrointestinal tract. Conclusion: HIFU for local ablation of pancreatic tumor combined with traditional Chinese medicine in the treatment of failure of chemotherapy in advanced pancreatic cancer is safe, effective, and light toxicity, worthy of further clinical study.

何胜利, 沈婕, 胡南华, 蔡芸芸, 孙贤俊, 刘鲁明. 清胰化积方联合高强聚焦超声消融治疗化疗失败晚期胰腺癌的临床疗效观察[J]. 亚洲肿瘤科病例研究, 2015, 4(1): 1-7.


[1] Burris 3rd, H.A., Moore, M.J., Andersen, J., et al. (1997) Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: A randomized trial. Journal of Clinical Oncology, 15, 2403-2413.
[2] Conroy, T., Desseigne, F., Ychou, M., Bouche, O., Guimbaud, R., Becouarn, Y., et al. (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. The New England Journal of Medicine, 364, 1817-1825.
[3] Von Hoff, D.D., Ervin, T., Arena, F.P., Chiorean, E.G., Infante, J., Moore, M., et al. (2013) Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. The New England Journal of Medicine, 369, 1691-1703.
[4] 沈晔华, 刘鲁明, 孟志强, 等 (2009) 以清胰化积方为主的中西医综合治疗晚期胰腺癌64例生存分析. 中医杂志, 1, 39-42.
[5] Lee, J.Y., Choi, B.I., Ryu, J.K., et al. (2011) Concurrent chemotherapy and pulsed high-intensity focused ultrasound therapy for the treatment of unresectable pancreatic cancer: Initial experiences. Korean Journal of Radiology, 12, 176-186.
[6] Moore, M.J., Goldstein, D., Hamm, J., et al. (2007) Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. Journal of Clinical Oncology, 25, 1960-1966.
[7] Dragovich, T., Laheru, D., Dayyani, F., et al. (2014) Phase II trial of vatalanib in patients with advanced or metastatic pancreatic adenocarcinoma after first-line gemcitabine therapy (PCRT O4-001). Cancer Chemotherapy and Pharmacology, 74, 379-387.
[8] Wang, K., Chen, L., Meng, Z., et al. (2012) High intensity focused ultrasound treatment for patients with advanced pancreatic cancer: A preliminary dosimetric analysis. International Journal of Hyperthermia, 28, 645-652.
[9] Orsi, F., Arnone, P., Chen, W., et al. (2010) High intensity focused ultrasound ablation: A new therapeutic option for solid tumors. Journal of Cancer Research and Therapeutics, 6, 414-420.
[10] Gao, H.F., Wang, K., Meng, Z.Q., et al. (2013) High intensity focused ultrasound treatment for patients with local advanced pancreatic cancer. Hepatogastroenterology, 60, 1906-1910.
[11] Wu, F., Wang, Z.B., Zhu, H., et al. (2005) Feasibility of US-guided high-intensity focused ultrasound treatment in patients with advanced pancreatic cancer: Initial experience. Radiology, 236, 1034-1040.
[12] Yang, R., Sanghvi, N.T. and Rescorla, F.J. (1993) Liver cancer ablation with extracorporeal high intensity focused ultrasound. European Urology, 23, 17-22.
[13] 刘鲁明 (2005) 胰腺癌的中西医综合治疗进展. 癌症进展杂志, 6, 551-555.
[14] 沈晔华, 刘鲁明, 陈震, 等 (2010) 清胰化积中药联合动脉灌注化疗及放疗治疗无法手术切除胰腺癌患者41的临床研究. 中医杂志, 12, 1093-1097.
[15] Wang, P., Liu, L.M. and Chen, Z. (2010) Effect of Qingyi Huaji formula for inhibition of pancreatic cancer cell growth through down-regulating Ski expression. Zhongguo Zhong Xi Yi Jie He Za Zhi, 30, 942-945.