高强度聚焦超声联合全身性化学治疗对老年胰腺癌患者疼痛控制和生存获益的研究

Study on pain control and survival benefits of high-intensity focused ultrasound combined with systemic chemotherapy in older patients with pancreatic cancer

中文关键词: 胰腺肿瘤    高强度聚焦超声    老年    化学治疗    疼痛控制    生活质量    生存分析

英文关键词: pancreatic neoplasmshigh-intensity focused ultrasoundelderlychemotherapypain controlquality of lifesurvival analysis

中文摘要:

      目的 评估高强度聚焦超声(HIFU)联合全身性化学治疗对老年胰腺癌患者疼痛及生存获益的作用。方法 回顾性分析213例老年(≥65岁)胰腺癌患者临床资料，根据治疗方式分为单纯HIFU治疗(HIFU组，n=117)和HIFU联合化学治疗(联合组，n=96) 2组。比较2组治疗前后Karnofsky功能状态(KPS)评分、数字分级评分法(NRS)评分、糖类抗原19-9(CA19-9)水平、糖类抗原125(CA125)水平、总生存期(OS)及不良事件。结果 HIFU组与联合组中位OS分别为8.93个月和12.46个月(P=0.008)。治疗后1个月，联合组NRS评分及CA19-9水平在治疗前后的差值绝对值大于HIFU组，差异有统计学意义(P <0.05)。2组KPS评分及CA125水平在治疗前后的差值差异无统计学意义(P> 0.05)。2组不良事件发生率差异无统计学意义(P=0.830)。结论 HIFU联合化学治疗能一定程度延长老年胰腺癌患者OS并缓解疼痛，安全性较好。

英文摘要:

      Objective To evaluate the effects of high-intensity focused ultrasound(HIFU)combined with systemic chemotherapy on pain and survival benefit in older patients with pancreatic cancer.Methods Clinical data of 213 older(≥65 years)patients with pancreatic cancer were retrospectively analyzed.According to treatment method,patients were divided into two groups:HIFU group(including patients receiving HIFU alone,n=117)and combination group(including patients receiving HIFU combined with chemotherapy,n=96).Karnofsky performance status(KPS)score,numeric rating scale(NRS)score,carbohydrate antigen 19-9(CA19-9)level,carbohydrate antigen 125(CA125)level,overall survival(OS),and adverse events were compared between the two groups before and after treatment.Results The median OS in the HIFU group and the combination group was 8.93 months and 12.46 months,respectively(P=0.008).One month after treatment,the differences in NRS score and CA19-9 level before and after treatment in the combination group were greater than those in the HIFU group,with statistical significance(P＜0.05).There were no statistically significant differences between the two groups in the changes of KPS score and CA125 level before and after treatment(P＞0.05).There was no significant difference in the incidence of adverse events between the two groups(P=0.830).Conclusion HIFU combined with chemotherapy can extend OS and alleviate pain to a certain extent in older patients with pancreatic cancer.Its safety is relatively good.