• 1. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;
  • 2. Department of Respiratory Medicine, Nuclear Industry 416 Hospital, Chengdu 610051, China;
  • 3. Department of Medical Administration, 363 Hospital, Chengdu 610041, China;
LIYou-ping, Email: yzmylab@163.com
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Objective To explore the effectiveness and safety of high intensity focused ultrasound (HIFU) in the treatment of pancreatic cancer, so as to provide references for its clinical application. Methods PubMed, EMbase, The Cochrane Library (Issue 11, 2013), CBM, CNKI, VIP and WanFang Data were systematically searched up to November 2013 for randomized clinical trials (RCTs) and clinical controlled trials (CCTs) about HIFU in the treatment of pancreatic cancer. According to inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.0. Results A total of 23 studies (19 RCTs and 4 CCTs) were included, of which 14 studies reported safety. The results of meta-analysis showed that:survival rates at the 6th month and the 12th month, overall efficacy and clinical benefit rate in the HIFU plus radiation and chemotherapy group were significantly higher than those in groups treated with three dimensional conformal radiation therapy (3D-CRT) (P < 0.05), gemcitabine (GEM) (P < 0.05), GEM plus cisplatin (DDP) (P < 0.05), and GEM plus 5-fluorouracil (5-FU) (P < 0.05). The adverse effects (mainly including skin damage and fever) in the HIFU plus radiation and chemotherapy group was similar to those in the control group with no significant difference (P > 0.05). Conclusion Current evidence suggests that HIFU plus radiation and chemotherapy for pancreatic cancer is superior to other therapies with less adverse reaction. However, the poor quality of the included studies reduces the reliability of outcome to some extent. Thus, it is necessary to regulate and unify the criteria of diagnosis and outcome measures in the treatment of pancreatic cancer and improve the quality of study design and implementation in clinical studies, so as to provide high quality evidence for its clinical application.

Citation: LICui-cui, WANGYing-qiang, LIYou-ping, LIXiang-lian. Effectiveness and Safety of High-intensity Focused Ultrasound for Pancreatic Cancer: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2014, 14(11): 1332-1342. doi: 10.7507/1672-2531.20140216 Copy

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