Purpose: To introduce our clinical experience of using extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of patients with various kinds of solid tumors.
Methods and Materials: From December 1997 to October 2001, a total of 1038 patients with solid tumors underwent HIFU ablation in ten Chinese hospitals. The tumors included primary and metastatic liver cancer, malignant bone tumors, breast cancer, soft tissue sarcomas, kidney cancer, pancreatic cancer, abdominal and pelvic malignant tumors, uterine myoma, benign breast tumors, hepatic hemangioma and other solid tumors. Real-time ultrasound-guided HIFU therapeutic system (Chongqing Haifu (HIFU) Tech Co., Ltd, China) was used in this study. It consists of a diagnostic US device, units for computer automatic control, 6-direction movement and therapeutic planning system, an US generator, integrated US therapy transducers, and a degassed water circulation unit. The majority of treated lesions were more than 5 cm in diameter. Most of them were exposed at acoustic focal peak intensities from 5,000 to 15,000 W/cm2 in a single session with either 0.8 or 1.6 MHz. Our goals of HIFU ablation in patients with early-stage cancer were curative, and the HIFU targeted-region consisted of the primary cancer and a normal tissue margin about 1.5-2.0 cm around the cancer. But in patients with advanced-stage cancer HIFU was palliative, to impede tumor growth and to improve the quality of life.
Results: Pathological examination showed that the target region presented clear evidence of cellular destruction. Small blood vessels less than 2 mm in diameter were severely damaged. Furthermore, definite changes in malignant characteristics of treated cancer cell including proliferation, invasion, metastasis, and immortalisation were observed. Follow-up DSA, CT, MR and color Doppler US revealed that there was no, or reduced, blood supply in the treated-tumor, and SPECT showed that no uptake of radioisotope was observed after HIFU, both indicating a positive therapeutic response and an absence of viable tumor. Imaging at 6-12 months can showed obvious regression of the lesion. 4-year follow-up data were collected in patients with HCC, osteosarcoma, and breast cancer. Among patients treated with HIFU, an extremely low major complication rate was observed.
Conclusion: Non-invasive HIFU ablation is safe, effective, and feasible for the treatment of patients with various kinds of solid carcinomas. (F.W. is on the board of, an employee of, and a shareholder in Chongqing Haifu (HIFU) Tech Co. Ltd., China. Z.W. is on the board of, a shareholder in and a consultant to Chongqing Haifu (HIFU) Tech Co. Ltd.)
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