Luo Jun, Ren Xueyi, Yu Tinghe
Hospital of Stomatology, Chongqing Medical University , Chongqing , China.
Int J Radiat Biol. 2015 Jun;91(6):480-5. doi: 10.3109/09553002.2015.1021962. Epub 2015 Mar 28.
To evaluate the efficacy of extracorporeal ultrasound-guided high intensity focused ultrasound (HIFU) based upon data in controlled clinical trials in China.
Data in 75 controlled trials involving in 833 cases of benign and 4559 cases of malignant diseases were re-evaluated.
In uterine fibroid, ectopic pregnancy and chyluria, the efficacy of HIFU was similar to that of surgery or drugs. The survival rate of HIFU plus radiotherapy was less than that of radical surgery in operable liver cancer. In inoperable liver cancer, the survival benefit of HIFU was similar to that of radio frequency, transarterial chemoembolization or γ-knife. In pancreatic cancer, HIFU and chemotherapy produced similar survival rates, and HIFU did not improve the effect of chemotherapy or radiotherapy. HIFU did not enhance hormone therapy in prostate cancer. Preoperative HIFU increased rates of complete removal and of survival in retroperitoneal sarcoma, and increased the response rate in breast cancer. The response rate agreed with the survival benefit (κ = 0.71, p = 0.0002).
HIFU should be curtailed in resectable cases and be an alternative in inoperable cases; a combination regimen should not be recommended. The Response Evaluation Criteria in Solid Tumors can be applied to HIFU.
基于中国的对照临床试验数据，评估体外超声引导下高强度聚焦超声（HIFU）的疗效。
对75项对照试验的数据进行重新评估，这些试验涉及833例良性疾病和4559例恶性疾病。
在子宫肌瘤、异位妊娠和乳糜尿方面，HIFU的疗效与手术或药物相似。在可手术切除的肝癌中，HIFU联合放疗的生存率低于根治性手术。在不可手术切除的肝癌中，HIFU的生存获益与射频、经动脉化疗栓塞或伽马刀相似。在胰腺癌中，HIFU和化疗产生的生存率相似，且HIFU未改善化疗或放疗的效果。HIFU未增强前列腺癌的激素治疗效果。术前HIFU提高了腹膜后肉瘤的完整切除率和生存率，并提高了乳腺癌的缓解率。缓解率与生存获益相符（κ = 0.71，p = 0.0002）。
在可切除病例中应减少使用HIFU，在不可手术病例中可作为一种替代方法；不建议采用联合治疗方案。实体瘤疗效评价标准可应用于HIFU。
