Objective To systematically review the effectiveness and safety of high intensity focused ultrasound (HIFU) for myoma of uterus fibroid. Methods Such databases as PubMed, EMbase, Web of Science, The Cochrane Library (Issue 10, 2012), CBM, CNKI, and WanFang Data were electronically searched from inception to November 2012 for randomized controlled trials on HIFU for myoma of uterus fibroid. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.0 software, and the quality levels of evidence were graded using GRADEpro 3.2 software. Results A total of 6 trials were included, involving 643 patients. The results of meta-analysis showed that, HIFU was similar to surgery in complete and partial fibroid ablation, with no significant difference; HIFU and radiofrequency were different in complete and partial fibroid ablation, with significant differences; and HIFU was superior to mifepristone in complete fibroid ablation, with a significant difference. Conclusion HIFU is an alternative, non-invasive, safe and effective treatment for myoma of uterus fibroid.
Objective To study the mechanism of high intensity focused ultrasound (HIFU) and discuss its clinical significance in the treatment of mid-late stage liver cancer. Methods The patients with mid-late stage liver cancer were treated with HIFU. The changes of photography, pathology and immunology after operation were evaluated. Results It was shown that the results of the photographic, pathologic and immunologic examinations changed during the treatment of the patients with HIFU. Conclusion HIFU is effective and safe for the treatment of mid-late stage liver cancer.
ObjectiveTo evaluate the effects of high intensity focused ultrasound (HIFU) on hepatic cancer cells spreading in blood.Methods AFP mRNA in peripheral blood of 19 patients with hepatocellular carcinoma was detected before and after HIFU therapy by RTPCR.Results①Before HIFU therapy, 11 of 19 cases were AFP mRNA positive (57.9%), while the control group were all negative. AFP mRNA was correlated with some clinical parameters such as serum AFP level, tumor size, portal vein embolism and extrahepatic metastasis (P＜0.05). ②In 8 cases with preoperative AFP mRNA negative, only 2 cases became AFP mRNA positive immediately after therapy, and one of the 2 cases became negative again after 72 hours. One week after HIFU therapy, the AFP mRNA positive rate (31.6%) was much lower than the preoperative positive rate (57.9%), but there was no statistical significance (Pgt;0.05). ③After one week of HIFU therapy, the AFP mRNA positive rate of the group with tumor size less than 8 cm was much lower than that of tumor size larger than 8 cm (P＜0.05). ConclusionHIFU may reduce the spreading of hepatocellular carcinoma cells in blood. It is effective for patients with tumor size less than 8 cm.
bjectiveTo evaluate the efficacy and limits of high intensity focused ultrasound (HIFU) in tumor treatment. MethodsThe references about the application of HIFU in tumor treatment in recent years were reviewed.ResultsHIFU caused localized hyperthermia at predictable depth in a few seconds to make the tumor tissue coagulative necrosis without injuring surrounding tissue. HIFU treatment had the advantages of low morbidity, noninvasiveness, avoidance of systemic side effects, and repeatitiveness. However, the utilization of HIFU sometimes could be limited by some factors such as imaging technique, organ movement, incomplete tissue destruction, etc.ConclusionHIFU is a promising noninvasive therapy for tumor treatment, though there are lots of problems to be further studied.
Objective To assess the survival of patients receiving high intensity focused ultrasound (HIFU) and investigate the prognostic factors for primary hepatocellular carcinoma (PHCC) victims with HIFU application. Methods One hundred and eighty-seven patients with PHCC undergoing HIFU treatment in our department were enrolled into this study from June 2004 to June 2007. Among them, 101 patients were males and 86 were females (mean age: 47.7 years old, range: 19-79 years old). The average tumor size was 5.7 cm (range: 0.5-18.0 cm). Of these 187 patients, numbers according to Child-Pugh grade of A, B and C were 104, 52 and 31, respectively. According to TNM system, 45, 111 and 31 patients were in stage Ⅱb, Ⅲa and Ⅲb respectively. Kaplan-Meier model and log-rank test were used in univariate analysis and Cox regression model was used in multivariate analysis to identify prognostic factors for survival. Results Survival period was (17.3±2.5) months after HIFU treatment of PHCC. The overall survival rate of 3-month, 6-month, 1-year and 2-year were 79.1%, 60.1%, 35.7%, and 29.3%， respectively. It was significant that tumor number (P=0.02), size (P=0.04)， AFP (P=0.04)， Child-Pugh grade (P=0.00)， TNM stage (P=0.01)， tumor metastasis (P=0.03) before HIFU， and tumor recurrence after HIFU (P=0.02) and standard treatment (P=0.02) were prognostic factors by single factor analysis. The following factors were identified as independent prognostic factors for overall survival by multivariate model: standard treatment protocol (P=0.000), and TNM stage (P=0.004) and Child-Pugh grade (P=0.009) before HIFU. Conclusion It is used for improving overall survival rate to found PHCC early, protect liver function, examine comprehensively before HIFU treatment, focus on standard treatment and auxiliary treatment.
【Abstract】ObjectiveTo investigate the effect of high intensity focused ultrasound (HIFU) on the immunity of patients with advanced primary liver cancer (PLC). MethodsForty cases of PLC admitted to our institution from Mar. 2003 to Dec. 2003 were included in this study. Patients were divided into 2 groups and received either HIFU or radiofrequency ablation (RFA) treatment randomly. CD3, CD4, CD8, CD4/CD8, NK, IL-2, TNF were chosen to assess the immune status before and after treatment. The results were compared statistically. ResultsThe survival rate after HIFU was 80.0%, 61.1%, 42.9%, 33.3% at 3 months, 6 months, 9 months and 1 year respectively, which was similar to that after RFA treatment. The changes of immunity parameters of CD3, CD4, CD8, CD4/CD8, NK, IL-2 and TNF were not significant after HIFU treatment. In addition, the differences of those parameters between HIFU group and RFA group were insignificant. ConclusionThere are no detrimental effects on immunity in the early period after HIFU treatment.
ObjectiveTo explore the safety and effectiveness of high intensity focused ultrasound (HIFU) in treatment of hepatic echinococcosis. MethodsThe clinical data of 8 patients with hepatic echinococcosis from 2008 to 2010 in the HIFU treatment center of The Second Affiliated Hospital of Chongqing Medical University were analyzed retrospectively, the effect of HIFU treatment, postoperative liver area pain, fever, skin burn and other complications were evaluated, the prognosis and recurrence were followed-up. ResultsAll the clinical manifestations and imaging manifes-tations of these 8 patients were improved after HIFU treatment. The liver functions of all the patients were injuried, which all were returned to normal within 5 days. Three patients suffered from fever and recovered within 6 days. Six patients appeared pain of liver area and relieved within 7 days. Operation area skin was basically normal, except 3 cases of mild swelling, no special complications happened. ConclusionFrom the limited data initially shows that it is a safe and effec-tive method of HIFU in treatment of hepatic echinococcosis, which is little invasion and less postoperative complications.
Objective To investigate the clinical effect of high intensity focused ultrasound (HIFU) and uterine artery embolization (UAE) in the treatment of cesarean scar pregnancy (CSP). Methods A total of 152 patients with CSP diagnosed by B-type ultrasonography were enrolled prospectively in this study from June 2014 to May 2016 in Chengdu Women and Children’s Central Hospital and Suining Central Hospital. Six patients from Chengdu Women and Children’s Central Hospital and 84 from Suining Central Hospital for Volunteered HIFU treatment were regarded as observation group. The other 62 patients from Chengdu Women and Children’s Central Hospital were selected to accept UAE treatment voluntarily were designated as control group. The clinical efficacy and therapeutic safety of the two groups were compared after the treatment. Results Eighty-two patients (91.1%) in the observation group and 32 (51.6%) in the control group had a bleeding volume equal to 100 mL or lower during complete curettage of uterine cavity (P<0.05). The hospitalization expenses of the above two groups were respectively (25 126.51±1 473.49) and (32 928.42 ±1 579.35) yuan (P<0.05). The hospitalization time was (11.03±1.52) and (10.65±1.87) days respectively, and the difference was not statistically significant (P>0.05). There was no significant difference in the normal rate of human chorionic gonadotropin recovery between the observation group and the control group at 14 days after treatment (P>0.05). Eighty-seven patients (96.7%) in the observation group and 51 (82.3%) in the control group had their menstrual recovery to normal level at 2 months after treatment, and the difference was statistically significant (P<0.05). The incidence of postoperative complications was 1.1% and 6.4% in the observation group and the control group, respectively, and the difference was not statistically significant (P>0.05). Conclusions HIFU in the treatment of CSP is safe and effective. Compared with UAE, HIFU requires less cost with fewer complications, which is worth promoting.
ObjectivesTo systematically review the safety and effectiveness of uterine artery embolization (UAE), surgery and high intensity focused ultrasound (HIFU) in the treatment of uterine fibroids.MethodsPubMed, EMbase, The Cochrane Library, Web of Science, WanFang Data and CNKI databases were electronically searched to collect relevant studies on comparing the safety and effectiveness of UAE, surgery and HIFU in the treatment of uterine fibroids from January 2000 to August 2019. Two reviewers independently screened the literature, extracted the data and evaluated the risk of bias of included studies, network meta-analysis was performed by ADDIS 1.16.8 software and Stata 14.0 software.ResultsA total of 11 trials (22 references) involving 3469 patients were included. Compared with surgery, UAE and HIFU patients had higher quality of life (1-year follow-up) improvement, and UAE was higher than HIFU. Network meta-analysis showed that patients treated with HIFU had the lowest incidence of major complications within 1 year, followed by UAE, and surgery. Patients treated with HIFU and UAE had shorter hospitalization and quicker recovery time than surgery. The rate of further intervention after surgery treatment might be lower than that of UAE and HIFU.ConclusionsUAE has the highest quality of life improvement (1-year follow-up) for uterine fibroids. HIFU and UAE are safer with shorter hospital stays and quicker recovery time compared with surgery. However, both UAE and HIFU have the risk of re-treatment. However, limited by the number and quality of included studies, the above conclusions are needed to be verified by more high-quality studies.