Biomedical Research

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Randomized controlled trial of follow-up in pancreatic cancer patients treated by intermediate frequency ultrasound combined with opioid analgesic

Objective: The objective is to explore the clinical efficacy and safety of intermediate frequency ultrasound combined with potent opioid analgesic in treating malignant pancreatic cancer.

Methods: 162 malignant pancreatic cancer patients admitted in our hospital during February, 2010- February, 2013 were selected. The patients were divided into the observation group and control group according to the random number table method with 81 patients in either group. The patients in both groups received opioid analgesic (morphine), and the patients in the observation group were also treated with intermediate frequency ultrasound (high intensity focused ultrasound). The patients were followed up for 2 years to observe the therapeutic efficacy, safety and survival situation.

Results: The clinical benefit rate (CBR) was 84.0% (68 cases) in the observation groups; the CBR was 40.7% (33 cases) in the control group. The CBR in the observation group was significantly higher than the control group (P<0.05). After treatment, the visual analogue score (VAS) and morphine dose in the observation group were both significantly decreased (P<0.05), however the morphine dose in the control group was not changed (P>0.05), the VAS in the control group was also decreased but not as much as the observation group (P<0.05). After treatment, the serum vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) were both significantly decreased in the observation group (P<0.05), but were not changed in the control group (P>0.05). The vital signs in the two groups were not obviously changed, and there was no adverse reaction such as skin burn or organ perforation. All the patients in the two groups were effectively followed up, the average follow up time was (23.2 ± 9.1) months. The median survival time (MST) was (6.4 ± 1.3) months in the observation group and (3.6 ± 0.8) months in the control group. The MST in the observation group was significantly higher than the control group (P<0.05).

Conclusion: Intermediate frequency ultrasound combined with opioid analgesic can effectively alleviate cancerous pain, decrease VEGF and HGF, and inhibit the progress of the cancer in malignant pancreatic cancer patients, which is a safe and effective therapeutic regimen. It is significant in prolonging the survival time of patients.

Author(s): Li Li, Hong-Liang Li, Xiao-Hui Wang, Yibin Xie