Current Status of Local Ablative Techniques in the Treatment of Pancreatic Cancer

Date, Ravindra

doi:10.1097/01.mpa.0000229006.39667.ea

Cited by 14 publications

(13 citation statements)

References 10 publications

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“…Therefore, these tumors are a potential setting for PI3K/AKT/mTOR pharmacological interventions[117]. …”

Section: The Futurementioning

confidence: 99%

New therapeutic approaches to metastatic gastroenteropancreatic neuroendocrine tumors: A glimpse into the future

Cidon

2017

WJGO

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Neuroendocrine (NE) gastroenteropancreatic tumors are a heterogeneous group of neoplasias arising from neuroendocrine cells of the embryological gut. Their incidence have increased significantly over the past 3 decades probably due to the improvements in imaging and diagnosis. The recent advances in molecular biology have translated into an expansion of therapeutic approaches to these patients. Somatostatin analogs, which initially were approved for control of hormonal syndromes, have recently been proven to inhibit tumor growth. Several new drugs such as antiangiogenics and others targeting mammalian target of rapamycin pathways have been approved to treat progressive pancreatic neuroendocrine tumors (NETs) although their role in non-pancreatic is still controversial. The treatment of NETs requires a coordinated multidisciplinary approach. The management of localized NETs primarily involves surgical resection followed by surveillance. However, the treatment of unresectable and/or metastatic disease may involve a combination of surgical resection, systemic therapy, and liver-directed therapies with the goal of alleviating symptoms of peptide release and controlling tumor growth. This article will review the current therapeutic strategies for metastatic gastroenteropancreatic NETs and will take a glimpse into the future approaches.

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“…Therefore, these tumors are a potential setting for PI3K/AKT/mTOR pharmacological interventions[117]. …”

Section: The Futurementioning

confidence: 99%

New therapeutic approaches to metastatic gastroenteropancreatic neuroendocrine tumors: A glimpse into the future

Cidon

2017

WJGO

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“…Furthermore, closely adjacent critical structures such as duodenum, portal vein and common bile duct are at risk of thermal injury. These limitations have been the main impeding factors in application of RFA to treat pancreatic cancer [12]. …”

Section: Discussionmentioning

confidence: 99%

“…Radiofrequency (RF)-mediated ablative thermal energy has been increasingly used to treat solid parenchymal tumors. RF ablation of unresectable pancreatic tumors has been reported [3, 7, 9-11], but carries a high risk of pancreatitis and severe thermal injuries to critical structures adjacent to the pancreatic tumors, such as duodenum, portal vein or common bile duct [3, 12-14]. Some serious complications require operative intervention and therefore surgery despite the presence of unresectable tumor [3].…”

Section: Introductionmentioning

confidence: 99%

Intratumoral radiofrequency hyperthermia-enhanced direct chemotherapy of pancreatic cancer

et al. 2016

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PurposeTo investigate the technical feasibility of using ultrasound-guided intratumoral radiofrequency hyperthermia (RFH) to enhance local chemotherapy of rat orthotopic pancreatic cancers.Materials and MethodsOrthotopic pancreatic cancer masses were established by inoculating luciferase/mCherry labeled-pancreatic cancer cells into the pancreatic tails of Lewis model rats via a laparotomy approach. Twenty-four rats with pancreatic cancer and 24 mice with subcutaneous pancreatic cancer xenografts in four study groups (n = 6/group) received various treatments: i) combination therapy of intratumoral MR imaging-heating-guidewire-mediated RFH (42oC) plus local chemotherapy (gemcitabine); ii) intratumoral chemotherapy alone; iii) RFH alone; and (iv)phosphate-buffered saline (PBS). Transcutaneous ultrasound imaging was used to guide the treatment and subsequently follow changes in tumor sizes. Bioluminescence optical imaging was performed to follow photon signal changes. Sonographic and optical findings were correlated with histology at 14 days.ResultsOptical imaging demonstrated a significantly decreased bioluminescence signal in mice with combination therapy group, compared with the other control groups (0.51±0.18 VS 1.6±0.4 VS 3.18±0.9 VS 3.5±0.96, p < 0.05). Ultrasound imaging showed the smallest tumor volumes of both mice and rat group with the combination therapy, compared with other control groups (0.62±0.16 VS 1.25±0.19 VS 2.28±0.25 VS 2.64±0.26, p < 0.05) and (0.75±0.18 VS 1.31±0.30 VS 1.61±0.28 VS 1.72±0.28, p < 0.05). Both imaging findings were confirmed by histologic correlation.ConclusionIntratumoral RFH can augment the chemotherapeutic effect in an orthotopic pancreatic cancer model.

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“…As the distance from the electrode increases, the temperature tends to decrease[26]. The optimal temperature for thermal ablation was demonstrated in a porcine model by Date[42] in 2005. It was concluded that optimal thermokinetics was generated at a temperature of 90 °C when applied for 5 min.…”

Section: Time and Temperature Utilized In Rfamentioning

confidence: 99%

Endoscopic ultrasound-guided radiofrequency ablation in gastroenterology: New horizons in search

Chaudhary¹,

Sun²

2017

WJG

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Radiofrequency ablation (RFA) has been widely used for the treatment of various solid organ malignancies. Over the last decade, endosonographers have gradually shifted the application of RFA from porcine models to humans to treat a spectrum of diseases. RFA is performed in patients with pancreatic carcinoma who are not candidates for surgery. In this paper, we will discuss various indications for RFA, its procedural details and complications. At present, endoscopic ultrasound-guided RFA is gradually incorporated into the management of various diseases and opens a new avenue for disease treatment.

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Current Status of Local Ablative Techniques in the Treatment of Pancreatic Cancer

Cited by 14 publications

References 10 publications

New therapeutic approaches to metastatic gastroenteropancreatic neuroendocrine tumors: A glimpse into the future

New therapeutic approaches to metastatic gastroenteropancreatic neuroendocrine tumors: A glimpse into the future

Intratumoral radiofrequency hyperthermia-enhanced direct chemotherapy of pancreatic cancer

Endoscopic ultrasound-guided radiofrequency ablation in gastroenterology: New horizons in search

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