Data Sheet 1_High-intensity focused ultrasound as a combined approach for the treatment of recurrent low-grade endometrial stromal sarcoma: a case report and literature review.pdf

BackgroundSurgery is the primary treatment for Endometrial Stromal Sarcoma (ESS), however, a substantial proportion of patients with ESS experience recurrence or metastasis. Currently, surgery and local ablation are the main treatments for recurrent ESS followed by chemotherapy, radiotherapy, immunotherapy, targeted therapy, and anti-estrogen therapy. Surgery and local ablation are invasive treatments and may carry risks such as intestinal damage and the risk of massive bleeding from tumor rupture. For patients who refuse or are unable to undergo surgery and local ablation, conservative treatment is not effective, and there is currently no definitive effective non-invasive or combined treatment plan.
Case presentationThis report presents a case of a patient with recurrent endometrial stromal sarcoma who refused surgical and local ablation treatments. After receiving HIFU treatment combined with chemotherapy, the progression of the tumor was effectively inhibited, the tumor volume significantly reduced, and liver function was restored during the HIFU period, providing an opportunity for chemotherapy.
ConclusionsHIFU combined with chemotherapy may provide a new treatment strategy for patients with recurrent, metastatic endometrial stromal sarcoma, or those who are unsuitable for surgery, local ablation, or those with poor baseline status unable to tolerate intensive chemotherapy.

背景：子宫内膜间质肉瘤（Endometrial Stromal Sarcoma, ESS）的首选治疗方案为手术治疗，但仍有相当比例的ESS患者会出现复发或转移。当前针对复发型ESS的主流治疗方式为手术与局部消融，后续辅以化疗、放疗、免疫治疗、靶向治疗及抗雌激素治疗。手术与局部消融属于有创操作，可能引发肠损伤、肿瘤破裂大出血等风险。对于拒绝或无法接受手术及局部消融的患者，保守治疗效果欠佳，目前尚无明确有效的无创或联合治疗方案。
病例报告：本病例报告呈现1例拒绝手术与局部消融治疗的复发型子宫内膜间质肉瘤患者。该患者接受高强度聚焦超声（High Intensity Focused Ultrasound, HIFU）联合化疗后，肿瘤进展得到有效抑制，肿瘤体积显著缩小，且治疗期间肝功能恢复正常，为后续化疗提供了契机。
结论：高强度聚焦超声联合化疗或可为复发、转移性子宫内膜间质肉瘤患者，或是不适宜接受手术、局部消融治疗，抑或是基线状态较差无法耐受强化疗的患者，提供全新的治疗策略。