微无创治疗时代下高强度聚焦超声治疗 在胰腺癌中的应用

Application of High-Intensity Focused Ultrasound in Pancreatic Cancer in the Era of Minimally and Non-Invasive Therapy

摘要: 在微无创治疗成为肿瘤治疗新趋势的今天，高强度聚焦超声(High Intensity Focused Ultrasound, HIFU)作为一种高效、非侵入的局部消融手段，正逐渐在胰腺癌治疗中展现出其独特的意义。胰腺癌历来死亡率高、生存期短，而HIFU凭借其安全、无创、可重复、患者耐受性好等优势，为那些无法手术、多线治疗失败或身体条件较差的患者提供了新的治疗选择。本文系统综述了高强度聚焦超声治疗胰腺癌的作用原理，包括其直接热消融肿瘤、有效缓解癌痛以及可能调节肿瘤免疫微环境的多重效应，并分析了目前高强度聚焦超声单独或联合放化疗、免疫治疗在不可切除胰腺癌中的应用现状，总结其对患者生存质量与生存期的积极影响。同时，文章也探讨了该技术目前面临的挑战与未来发展方向，以期为高强度聚焦超声在胰腺癌临床实践中的进一步应用提供参考与思路。

Abstract: As minimally and non-invasive therapy becomes a new trend in cancer treatment, high-intensity focused ultrasound (HIFU) is gradually demonstrating its unique significance in pancreatic cancer management as an efficient, non-invasive local ablation modality. Pancreatic cancer has long been associated with high mortality and short survival. HIFU, with its favorable safety profile, non-invasive nature, repeatability, and good patient tolerance, offers a new therapeutic alternative for patients who are ineligible for surgery, have experienced failure of multiple lines of therapy, or are in poor general condition. This article provides a systematic review of the mechanisms underlying HIFU treatment for pancreatic cancer, encompassing its multiple effects—from direct thermal ablation of tumors and effective alleviation of cancer-related pain to the potential modulation of the tumor immune microenvironment. It further analyzes the current status of HIFU application, both as a standalone treatment and in combination with radiotherapy, chemotherapy, or immunotherapy, in patients with unresectable pancreatic cancer, summarizing its positive impact on patient quality of life and survival. Furthermore, the paper discusses the existing challenges and future directions for this technology, aiming to offer insights and perspectives for its further integration into clinical practice for pancreatic cancer.