Wu Feng
Clinical Center for Tumor Therapy of 2nd Affiliated Hospital, and Institute of Ultrasonic Engineering in Medicine, Chongqing University of Medical Sciences, Chongqing, China.
Minim Invasive Ther Allied Technol. 2006;15(1):26-35. doi: 10.1080/13645700500470124.
The ideal treatment of localized cancer should cause the complete death of tumor cells without damage to surrounding normal tissue. High intensity focused ultrasound (HIFU) is such a potential treatment, which can induce complete coagulation necrosis of a targeted tumor, at depth, through the intact skin. The concept of using HIFU as a non-invasive therapy has attracted attention in medicine for 60 years. Recently, it has received increasing interest as a promising modality for the treatment of localized solid malignancies. The goal of this article is to introduce recent clinical developments in the use of extracorporeal HIFU ablation for solid tumors, including those of liver, breast, bone, kidney, pancreas, soft tissue, and uterus. It describes the physical principles and ablative mechanisms, three-dimensional therapeutic regimes, and medical imaging used in HIFU. Currently, large numbers of patients with solid malignancy are already treated using HIFU, and short-term clinical results are very encouraging. However, large-scale randomized clinical trials are necessary to evaluate long-term efficacy of HIFU treatment for solid malignancies. It is concluded that this non-invasive ablation can be considered as a conventional therapy for widespread clinical use only when the results from prospective, randomized clinical trials worldwide are available.
局部癌症的理想治疗方法应能使肿瘤细胞完全死亡，同时不损伤周围正常组织。高强度聚焦超声（HIFU）就是这样一种有潜力的治疗方法，它可以通过完整的皮肤，在深部诱导靶向肿瘤发生完全凝固性坏死。将HIFU用作非侵入性治疗的概念在医学领域已受到关注达60年之久。最近，它作为一种治疗局部实体恶性肿瘤的有前景的方式，受到了越来越多的关注。本文的目的是介绍体外HIFU消融治疗实体肿瘤（包括肝脏、乳腺、骨骼、肾脏、胰腺、软组织和子宫的肿瘤）的近期临床进展。它描述了HIFU的物理原理和消融机制、三维治疗方案以及所使用的医学成像。目前，已有大量实体恶性肿瘤患者接受了HIFU治疗，短期临床结果非常令人鼓舞。然而，需要进行大规模随机临床试验来评估HIFU治疗实体恶性肿瘤的长期疗效。得出的结论是，只有当全球前瞻性随机临床试验的结果可用时，这种非侵入性消融才能被视为一种可广泛应用于临床的常规治疗方法。
