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高强度聚焦超声治疗结肠和胃癌肝转移的初步经验。

Preliminary experience using high intensity focused ultrasound for treating liver metastasis from colon and stomach cancer.

作者信息

Park Michael Yong, Jung Seung Eun, Cho Se Hyun, Piao Xiang-Hao, Hahn Seong Tai, Han Joon-Yeol, Woo In Sook

机构信息

Department of Radiology, St Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea.

出版信息

Int J Hyperthermia. 2009 May;25(3):180-8. doi: 10.1080/02656730802641949.

Abstract

PURPOSE

To determine the efficacy and safety from our preliminary results of using high intensity focused ultrasound (HIFU) to treat liver metastasis from colon and stomach cancer.

MATERIALS AND METHODS

Ten patients with liver metastasis from colon cancer and three from stomach cancer underwent HIFU under general anesthesia. HIFU was performed using an extracorporeal, ultrasound-guided focused system. Complications during the study, extent of coagulative necrosis at two-week follow up, and evidence of tumor on further follow up were analyzed. Patients were divided into four categories: (I) complete ablation with no evidence of recurrence on follow up; (II) apparent complete ablation of target mass with new foci of disease in the target organ or distant malignancy and no local tumor progression; (III) local tumor progression after apparent complete ablation; (IV) partial ablation.

RESULTS

Mean follow-up period was 22 weeks in the colon cancer group and 58 weeks in the stomach cancer group. The sum of total lesion size was between 1.8 cm and 21.4 cm (mean: 8.4 cm +/- 6.7 cm) for the colon cancer group and between 1.7 and 16.3 cm (mean: 8.8 cm +/- 7.3 cm) for the stomach cancer group. In the colon cancer group, one patient was categorized as category I, one as category II, three as category III, and the remaining five as category IV. The stomach cancer group showed two patients as category I, and one as category II.

CONCLUSION

For treating liver metastasis from colon and stomach cancer HIFU seems safe but its efficacy is questionable. Further research is warranted.

摘要

目的

根据我们使用高强度聚焦超声(HIFU)治疗结肠癌和胃癌肝转移的初步结果,确定其疗效和安全性。

材料与方法

10例结肠癌肝转移患者和3例胃癌肝转移患者在全身麻醉下接受了HIFU治疗。使用体外超声引导聚焦系统进行HIFU治疗。分析了研究期间的并发症、两周随访时的凝固性坏死范围以及进一步随访时的肿瘤证据。患者分为四类:(I)完全消融,随访无复发证据;(II)目标肿块明显完全消融,目标器官出现新的病灶或远处恶性肿瘤,且无局部肿瘤进展;(III)明显完全消融后局部肿瘤进展;(IV)部分消融。

结果

结肠癌组平均随访期为22周,胃癌组为58周。结肠癌组总病灶大小在1.8 cm至21.4 cm之间(平均:8.4 cm±6.7 cm),胃癌组在1.7至16.3 cm之间(平均:8.8 cm±7.3 cm)。在结肠癌组中,1例患者分类为I类,1例为II类,3例为III类,其余5例为IV类。胃癌组有2例患者为I类,1例为II类。

结论

对于治疗结肠癌和胃癌肝转移,HIFU似乎是安全的,但其疗效值得怀疑。有必要进行进一步研究。

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