Analysis Of Prognostic Factors Of Advanced Pancreatic Cancer Treated By High Intensity Focused Ultrasound And Technical Progress

Background:As one of the highest rates of clinical tumor incidence, pancreatic cancer is into a rising trend year by year. Clinical guidelines recommend that surgical resection is the only way to radical cure. The early symptoms of pancreatic cancer are often not obvious, easy to be ignored. There are60% patients with distant metastasis and 25% patients of locally advanced pancreatic cancer, who lost the opportunity of radical surgery. The palliative care, as a mainly way, is given to advanced pancreatic cancer,such as chemotherapy, radiation therapy, biological therapy, molecular targeted therapy. Analgesic is also used to symptomatic treatment for improving the quality of life of patients. But the survival situation of advanced pancreatic cancer patients is still not optimistic.High Intensity Focused Ultrasound(HIFU), which uses focused ultrasound energy for therapeutic methods such as tissue ablation from an external body, is a new ultrasound technology, is a new kind of noninvasive treatment technology. HIFU is used in the treatment of pancreatic cancer astopical treatment more than ten years. The combined therapy mainly composed of HIFU should be adopted in the patients with advanced pancreatic cancer to improve the survival rate.Objective:1. Analysis the possible influence factors of survival time to help doctor make treatment plan of advanced pancreatic cancer patients.2.Through the contrastive analysis of the parameters such as treatment time to assess HIFU treatment efficiency and its influence to prognosis to advanced pancreatic cancer.Methods:A total of 57 patients would be analyzed which accepted HIFU treatment for advanced pancreatic cancer between January 2000 and December 2015. 1. Compared influence of age, sex, tumor stage,chemotherapy, anesthesia time, treatment time and irradiation time to prognosis to advanced pancreatic cancer by Kaplan-Meier. 2. Compared the anesthesia time, treatment time and irradiation time to assess HIFU treatment efficiency according to the year group and analyzed influence of HIFU treatment efficiency to prognosis to advanced pancreatic cancer.Results:Univariate analysis showed that MST of chemotherapy group was 12 months and MST of no chemotherapy group was 7 months. There was statistically significant(P=0.000,Log Rank ?2=17.025). MST of stage Ⅲwas 10 months and MST of stage Ⅳ was 8 months. There was statistically significant(P=0.023,Log Rank ?2=5.139).All patients who accepted HIFU treatment for advanced pancreatic cancer occurred mild postoperative adverse reactions which turned better after symptomatic treatment.Anesthesia time(P=0.050), treatment time(P=0.009)and irradiation time(P=0.019)were statistically significant from group 2000-2010 and group 2011-2015. The MST of group 2000-2010 was 10 months, mean survival time was 9.70±0.72 months. The MST of group 2011-2015 was10 months, mean survival time was 12.37±1.67 months. There was no significant difference of survival time from two groups(P=0.297).Conclusions:1. Chemotherapy and tumor stage could improve survival time for patients. Factors such as age, gender, anesthesia time, treatment time,irradiation time, had no significant effect on patient survival time. 2.With the development of HIFU technology, HIFU treatment efficiency was improved significantly, no effect on survival time of patients with pancreatic cancer.