Effectiveness and Safety of High-intensity Focused Ultrasound for Pancreatic Cancer: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 LICui-cui ^1,2 , WANGYing-qiang ³ ,  LIYou-ping ¹ , LIXiang-lian ¹

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;

Corresponding author：

LIYou-ping, Email: yzmylab@163.com

Keywords：

High-intensity focused ultrasound; Pancreatic cancer; Effectiveness; Safety; Systematic review

DOI：

10.7507/1672-2531.20140216

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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

1.	Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer, 2010, 127(12):2893-2897.
2.	袁耀宗, 何相宜.胰腺癌临床研究的热点问题.中华消化杂志, 2011, 31(5):356-357.
3.	赵平.我国胰腺癌诊治策略的研究.胰腺病学, 2002, 2(4):193-195.
4.	张宇, 毛伟敏.高强度聚焦超声及其在胰腺癌中的治疗.肿瘤学杂志, 2008, 14(11):951-953.
5.	陈平, 孙燕, 周际昌, 主编.肿瘤内科手册.第3版.北京:人民卫生出版社, 1996:30-34.
6.	Leslie T, Kennedy J, Illing R, et al. High-intensity focused ultrasound ablation of liver tumors:can radiological assessment predict the histological response? British Journal of Radiology, 2008, 81:564-571.
7.	Burris HA 3rd, Moore MJ, Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreatic cancer:a randomized trial. J Clin Oncol, 1997, 15(6):2403-2413.
8.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
9.	Balshem H, Helfand M, Schunemann HJ, et al. GRADE guidelines:3. Rating the quality of evidence. J Clin Epidemiol, 2011, 64(4):401-406.
10.	徐成, 胡月珍, 杨华清.高能聚焦超声联合三维适形放疗治疗晚期胰腺癌的临床观察.求医问药(学术版), 2012, 10(1):200-201.
11.	陈蛟红, 胡红超.三维适形放疗联合HIFU刀治疗胰腺癌的临床观察.中外医疗, 2011, 30(21):44.
12.	陈斌, 陈海燕, 周小祥, 等.中晚期胰腺癌三维适形放疗辅助高强度聚焦超声的临床观察.中国肿瘤临床与康复, 2010, 17(3):251-253.
13.	孙桂丽, 任志红.高强度聚焦超声联合三维适形放疗治疗晚期胰腺癌的临床观察.内蒙古民族大学学报, 2008, 14(2):105-106.
14.	史南, 欧善际, 彭晓晖.高强度聚焦超声联合吉西他滨治疗胰腺癌疗效观察.中国全科医学, 2011, 14(14):1597-1598.
15.	王楠娅, 赵恒军, 郑晓辉, 等.高强度聚焦超声联合吉西他滨治疗不可切除胰腺癌的临床疗效.临床肝胆病杂志, 2011, 27(11):1193-1195.
16.	虞阳, 张宇, 赵洪, 等.高能聚焦超声热疗对晚期胰腺癌的疗效观察.中华胰腺病杂志, 2009, 9(3):151-155.
17.	曾庆东, 吕丽红, 张秀国, 等.高强度聚焦超声联合健择治疗晚期胰腺癌的临床研究.中华肝胆外科杂志, 2006, 12(11):748-750.
18.	高宏建, 董戬, 胡墨, 等.高强度聚焦超声治疗晚期胰腺癌的近期疗效观察.中国医科大学学报, 2010, 39(6):491-493.
19.	卞晓山, 魏长宏, 王作志, 等. HIFU联合吉西他滨+顺铂治疗晚期胰腺癌的疗效观察.中国老年肿瘤学大会暨第三届CGOS学术年会论文集, 2009:254-258.
20.	陈平, 宋俊彪, 陈苏蓉, 等.健择联合化疗合并高能聚焦超声刀治疗晚期胰腺癌疗效观察.中外医疗, 2008, 27(22):55-56.
21.	高远, 冯军, 王庆才.高能聚焦超声"刀"合并gp方案治疗晚期胰腺癌的疗效观察.苏州大学学报·医学版, 2006, 26(3):428-430.
22.	吴同胜, 谭卫林, 郑树范, 等.高能聚焦超声联合动脉灌注化疗治疗晚期胰腺癌32例.肿瘤学杂志, 2009, 15(2):142-144.
23.	毛利峰, 寿晓雯, 李可夫.高能超声聚焦刀联合动脉灌注化疗治疗中晚期胰腺癌的疗效观察.中国实用医刊, 2009, 36(8):36-37.
24.	王榕生穆刘束.高能聚焦超声热疗合并化疗治疗晚期胰腺癌近期疗效观察.南京医科大学学报(自然科学版), 2003, 23(5):460-463.
25.	张宇, 洪勇强, 黄丽君, 等.高强度聚焦超声治疗进展期胰腺癌46例.中国肿瘤, 2009, 18(1):82-84.
26.	张一平, 赵景志, 乔新荣, 等.动脉灌注化疗联合高强度聚焦超声治疗胰腺癌的临床研究.介入放射学杂志, 2011, 20(12):964-968.
27.	殷廷哲, 金效民.高强度聚焦超声联合腹腔化疗治疗晚期胰腺癌的疗效观察.实用肿瘤学杂志, 2009, 23(2):146-147.
28.	秦成坤, 崔现平, 张振海. HIFU治疗无法手术切除的胰腺癌21例效果观察.山东医药, 2010, 50(51):1-3.
29.	杜春辉, 陆培新, 王连新, 等.三维适形放疗联合高强度聚焦超声治疗中晚期胰腺癌临床疗效.中国实用医药, 2012, 7(13):5-6.
30.	赵洪.高强度聚焦超声(HIFU)联合吉西他滨治疗晚期胰腺癌.第二届国际肿瘤靶向治疗大会暨中法靶向放疗论坛论文集, 2008:321-322.
31.	徐周敏, 裴峰, 陈坚, 等.高强度聚焦超声与伽玛刀治疗晚期胰腺癌的对比观察.中国肿瘤临床, 2010, 37(12):689-691.
32.	谢德荣陈岱佳, 滕虹, 等. Hifu联用双氟他滨治疗晚期胰腺癌的初步临床研究.岭南现代临床外科, 2001, 1(4):226-228.

1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer, 2010, 127(12):2893-2897.
2. 袁耀宗, 何相宜.胰腺癌临床研究的热点问题.中华消化杂志, 2011, 31(5):356-357.
3. 赵平.我国胰腺癌诊治策略的研究.胰腺病学, 2002, 2(4):193-195.
4. 张宇, 毛伟敏.高强度聚焦超声及其在胰腺癌中的治疗.肿瘤学杂志, 2008, 14(11):951-953.
5. 陈平, 孙燕, 周际昌, 主编.肿瘤内科手册.第3版.北京:人民卫生出版社, 1996:30-34.
6. Leslie T, Kennedy J, Illing R, et al. High-intensity focused ultrasound ablation of liver tumors:can radiological assessment predict the histological response? British Journal of Radiology, 2008, 81:564-571.
7. Burris HA 3rd, Moore MJ, Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreatic cancer:a randomized trial. J Clin Oncol, 1997, 15(6):2403-2413.
8. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
9. Balshem H, Helfand M, Schunemann HJ, et al. GRADE guidelines:3. Rating the quality of evidence. J Clin Epidemiol, 2011, 64(4):401-406.
10. 徐成, 胡月珍, 杨华清.高能聚焦超声联合三维适形放疗治疗晚期胰腺癌的临床观察.求医问药(学术版), 2012, 10(1):200-201.
11. 陈蛟红, 胡红超.三维适形放疗联合HIFU刀治疗胰腺癌的临床观察.中外医疗, 2011, 30(21):44.
12. 陈斌, 陈海燕, 周小祥, 等.中晚期胰腺癌三维适形放疗辅助高强度聚焦超声的临床观察.中国肿瘤临床与康复, 2010, 17(3):251-253.
13. 孙桂丽, 任志红.高强度聚焦超声联合三维适形放疗治疗晚期胰腺癌的临床观察.内蒙古民族大学学报, 2008, 14(2):105-106.
14. 史南, 欧善际, 彭晓晖.高强度聚焦超声联合吉西他滨治疗胰腺癌疗效观察.中国全科医学, 2011, 14(14):1597-1598.
15. 王楠娅, 赵恒军, 郑晓辉, 等.高强度聚焦超声联合吉西他滨治疗不可切除胰腺癌的临床疗效.临床肝胆病杂志, 2011, 27(11):1193-1195.
16. 虞阳, 张宇, 赵洪, 等.高能聚焦超声热疗对晚期胰腺癌的疗效观察.中华胰腺病杂志, 2009, 9(3):151-155.
17. 曾庆东, 吕丽红, 张秀国, 等.高强度聚焦超声联合健择治疗晚期胰腺癌的临床研究.中华肝胆外科杂志, 2006, 12(11):748-750.
18. 高宏建, 董戬, 胡墨, 等.高强度聚焦超声治疗晚期胰腺癌的近期疗效观察.中国医科大学学报, 2010, 39(6):491-493.
19. 卞晓山, 魏长宏, 王作志, 等. HIFU联合吉西他滨+顺铂治疗晚期胰腺癌的疗效观察.中国老年肿瘤学大会暨第三届CGOS学术年会论文集, 2009:254-258.
20. 陈平, 宋俊彪, 陈苏蓉, 等.健择联合化疗合并高能聚焦超声刀治疗晚期胰腺癌疗效观察.中外医疗, 2008, 27(22):55-56.
21. 高远, 冯军, 王庆才.高能聚焦超声"刀"合并gp方案治疗晚期胰腺癌的疗效观察.苏州大学学报·医学版, 2006, 26(3):428-430.
22. 吴同胜, 谭卫林, 郑树范, 等.高能聚焦超声联合动脉灌注化疗治疗晚期胰腺癌32例.肿瘤学杂志, 2009, 15(2):142-144.
23. 毛利峰, 寿晓雯, 李可夫.高能超声聚焦刀联合动脉灌注化疗治疗中晚期胰腺癌的疗效观察.中国实用医刊, 2009, 36(8):36-37.
24. 王榕生穆刘束.高能聚焦超声热疗合并化疗治疗晚期胰腺癌近期疗效观察.南京医科大学学报(自然科学版), 2003, 23(5):460-463.
25. 张宇, 洪勇强, 黄丽君, 等.高强度聚焦超声治疗进展期胰腺癌46例.中国肿瘤, 2009, 18(1):82-84.
26. 张一平, 赵景志, 乔新荣, 等.动脉灌注化疗联合高强度聚焦超声治疗胰腺癌的临床研究.介入放射学杂志, 2011, 20(12):964-968.
27. 殷廷哲, 金效民.高强度聚焦超声联合腹腔化疗治疗晚期胰腺癌的疗效观察.实用肿瘤学杂志, 2009, 23(2):146-147.
28. 秦成坤, 崔现平, 张振海. HIFU治疗无法手术切除的胰腺癌21例效果观察.山东医药, 2010, 50(51):1-3.
29. 杜春辉, 陆培新, 王连新, 等.三维适形放疗联合高强度聚焦超声治疗中晚期胰腺癌临床疗效.中国实用医药, 2012, 7(13):5-6.
30. 赵洪.高强度聚焦超声(HIFU)联合吉西他滨治疗晚期胰腺癌.第二届国际肿瘤靶向治疗大会暨中法靶向放疗论坛论文集, 2008:321-322.
31. 徐周敏, 裴峰, 陈坚, 等.高强度聚焦超声与伽玛刀治疗晚期胰腺癌的对比观察.中国肿瘤临床, 2010, 37(12):689-691.
32. 谢德荣陈岱佳, 滕虹, 等. Hifu联用双氟他滨治疗晚期胰腺癌的初步临床研究.岭南现代临床外科, 2001, 1(4):226-228.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of High-intensity Focused Ultrasound for Pancreatic Cancer: A Systematic Review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content