High-intensity focused ultrasound ablation combined with systemic therapy for unresectable colorectal cancer liver metastasis: A propensity score-matched analysis

作者全名："Tang, Fei; Zhong, Qin; Ni, Tingting; Xue, Yingbo; Wu, Jing; Deng, Rong; Zhang, Qi; Li, Yan; He, Xuanlu; Yang, Zhenzhou; Zhang, Yu"

作者地址："[Tang, Fei; Yang, Zhenzhou] Chongqing Med Univ, Affiliated Hosp 2, Dept Canc Ctr, Chongqing, Peoples R China; [Tang, Fei; Zhong, Qin; Ni, Tingting; Xue, Yingbo; Wu, Jing; Deng, Rong; Zhang, Qi; Li, Yan; He, Xuanlu; Zhang, Yu] Guizhou Prov Peoples Hosp, Dept Med Oncol, Guiyang, Peoples R China; [Zhang, Yu] Guizhou Prov Peoples Hosp, Natl Hlth Commiss Key Lab Pulm Immune Related Dis, Guiyang, Peoples R China"

通信作者："Tang, F; Yang, ZZ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Canc Ctr, Chongqing, Peoples R China.; Tang, F; Zhang, Y (通讯作者)，Guizhou Prov Peoples Hosp, Dept Med Oncol, Guiyang, Peoples R China."

来源：CANCER MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001111137000001

JCR分区：Q2

影响因子：2.9

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：ablation; colorectal cancer; high-intensity focused ultrasound; metastatic hepatic carcinoma; prognosis

摘要："Objective: Unresectable colorectal cancer liver metastasis (CRLM) remains a challenging obstacle that often prevents curative treatment. In this study, we retrospectively analyzed the efficacy and safety of high-intensity focused ultrasound (HIFU) as a local adjuvant therapy for systemic chemotherapy for patients with unresectable CRLM. HIFU is a noninvasive method previously demonstrated as efficacious for various solid malignancies.Methods: Propensity score matching was used for the combination therapy group (HIFU group, n = 59) and the observation group receiving systemic therapy only (No-HIFU group, n = 59). In addition, the survival benefit, adverse effects, and factors affecting prognosis following HIFU were evaluated.Results: The disease control rate was 77.9% and 62.7%, and the objective remission rate was 18.9% and 6.8% in the HIFU and non-HIFU groups, respectively. The survival analysis showed that median progression-free survival (mPFS) was 12.0 months and 11.0 months for the HIFU and non-HIFU groups, respectively (p = 0.002). The univariate and multivariate analysis showed that pre-treatment colorectal cancer liver metastasis lesion size was significantly associated with mPFS. In addition, patients that received a combination treatment for CRLM lesions <5.0 cm had a longer mPFS when compared to those receiving systemic therapy alone (13.0 months vs. 11.0 months, p = 0.001). In the HIFU group, patients with lesions <5.0 cm had a longer mPFS than patients with lesions >= 5.0 cm (13.0 months vs. 10.0 months, p = 0.04) (Figure 3B,C). Most treatment-related adverse events observed in both groups were grade 1-2. Only four cases (6.8%) of grade 1-2 skin burns were observed in patients in the HIFU group; no other statistically significant adverse events were observed.Conclusions: Our study showed that HIFU ablation targeting unresectable CRLM alongside systemic therapy safely and significantly improved local control rates and prolonged mPFS, especially for lesions smaller than 5.0 cm."

基金机构：Doctor Foundation of Guizhou Provincial People's Hospital

基金资助正文："We appreciate everyone who participated in the study, including the patients and their families. We also acknowledge the nurses and other clinical staff members who provided crucial assistance."