Wu Feng, Wang Zhi-Biao, Chen Wen-Zhi, Wang Wei, Gui Yongzhong, Zhang Ming, Zheng Guoqiang, Zhou Yongjian, Xu Guoliang, Li Ming, Zhang Chengwu, Ye Huiyi, Feng Ruo
Clinical Center for Tumor Theraphy, 2nd Affiliated Hospital, Chongqing University of Medical Sciences, 76 Linjiang Road, Chongqing 400010, China.
Ultrason Sonochem. 2004 May;11(3-4):149-54. doi: 10.1016/j.ultsonch.2004.01.011.
The ideal treatment of localized cancer should directly cause an irreversible and complete death of tumor cells without damage to surrounding normal tissue. High intensity focused ultrasound (HIFU) is such a potential treatment, which induces a complete coagulative necrosis of a tumor at depth through the intact skin. The idea that using an extracorporeal source of therapeutic ultrasound was introduced more than 50 years ago [J. Gen. Physiol. 26 (1942) 179]. However, up to now, most of the studies on HIFU have been dealing with animal experiments because this extracorporeal technique is very complicated in clinical applications. The purpose of this study is to introduce Chinese clinical experience of using extracorporeal HIFU for the treatment of patients with various kinds of solid tumor. From December 1997 to October 2001, a total of 1038 patients with solid tumors underwent HIFU ablation in China. Among them, 313 patients were treated at the Chongqing University of Medical Sciences, China. Pathological examination showed that the target region presented clear evidence of cellular destruction. Small blood vessels less than 2 mm in diameter were severely damaged. Follow-up diagnostic imaging revealed that there was no, or reduced, blood supply, and no uptake of radioisotope in the treated tumor after HIFU, both indicating a positive therapeutic response and an absence of viable tumor. Imaging at 6-12 months showed obvious regression of the lesion. Four-year follow-up data were significantly observed in patients with hepatocellular carcinoma, osteosarcoma, and breast cancer. An extremely low major complication rate was noted. It is concluded that HIFU ablation is a safe, effective, and feasible modality for the ablation of carcinomas.
局部癌症的理想治疗方法应能直接导致肿瘤细胞发生不可逆的完全死亡，同时不损伤周围正常组织。高强度聚焦超声（HIFU）就是这样一种具有潜力的治疗方法，它可通过完整皮肤在深部诱导肿瘤发生完全性凝固性坏死。利用体外治疗超声源的想法早在50多年前就已提出[《普通生理学杂志》26(1942)179]。然而，到目前为止，大多数关于HIFU的研究都集中在动物实验上，因为这种体外技术在临床应用中非常复杂。本研究的目的是介绍中国应用体外HIFU治疗各类实体瘤患者的临床经验。1997年12月至2001年10月，中国共有1038例实体瘤患者接受了HIFU消融治疗。其中，313例患者在中国重庆医科大学接受治疗。病理检查显示，靶区有明确的细胞破坏证据。直径小于2mm的小血管受到严重损伤。随访诊断成像显示，HIFU治疗后，治疗的肿瘤内无血供或血供减少，且无放射性同位素摄取现象，这均表明治疗反应良好且无存活肿瘤。6 - 12个月的成像显示病变明显缩小。对肝细胞癌、骨肉瘤和乳腺癌患者进行了显著的四年随访数据观察。观察到极低的严重并发症发生率。结论是，HIFU消融是一种安全、有效且可行的癌症消融方式。
