Effects of High‐Intensity Focused Ultrasound for Treatment of Abdominal Lymph Node Metastasis From Gastric Cancer

Abstract

espite a consistent decrease in disease incidence, gastric cancer remains the fourth most common cancer and the second most common cause of cancer-related deaths worldwide. 1,2 Numerous cases of gastric cancer have lymph node metastasis because of complex lymphatic drainage in the stomach. Moreover, a high rate of locoregional lymph node recurrence occurs after radical surgery. 3 Although evidence suggests that chemotherapy does confer a survival benefit, and the National Comprehensive Cancer Network is currently investigating chemotherapy with fluorouracil, cisplatin, and taxane, the prognosis of advanced gastric cancer, including cancer with abdominal lymph node metastasis, is still very poor. [4][5][6] Meiling Zhang, MD, Lingxiang Liu, MD, Jian Wang, MD, Kaihua Lu, MD, Yongqian Shu, MD, Rongsheng Wang, MD, Ping Liu, MD Received February 4, 2014, ORIGINAL RESEARCHObjectives-This retrospective study aimed to compare the efficacy and safety of combination treatment with high-intensity focused ultrasound (HIFU) and chemotherapy to those of chemotherapy alone for treatment of the abdominal lymph node metastasis from gastric cancer.Methods-A total of 185 patients with gastric cancer and abdominal lymph node metastasis were enrolled and divided into 2 groups: group A received chemotherapy alone (n = 102); group B received HIFU combined with chemotherapy (n = 83). The clinical efficacy and safety of the groups were then analyzed.Results-The overall response rates of groups A and B were 34.3% and 47.0%, respectively (P = .046). The pain relief rates in groups A and B were 51.6% and 75.0% (P = .039). At the data cutoff, the median survival times of groups A and B were 8.6 and 11.9 months (P < .05). The adverse reactions in the groups did not show significant differences (P > .05). Among the patients treated with HIFU and chemotherapy, those with small abdominal lymph nodes (diameter <3 cm) had a better prognosis than those with large nodes (diameter ≥3 cm).Conclusions-In patients with gastric cancer and abdominal lymph node metastasis, the combination of HIFU and chemotherapy can provide clinical benefits. Highintensity focused ultrasound could effectively facilitate treatment of abdominal lymph node metastasis from gastric cancer.

Selective ablation of cancer cells with low intensity pulsed ultrasound

“…High intensity focused ultrasound (HIFU) is a non-invasive therapeutic modality used clinically for tumor ablation [1][2][3][4][5]. By producing local hyperthermia and destructive cavitation [6], HIFU induces cell lysis, increases chemotherapeutic uptake [4,7], and stimulates systemic anti-tumor immune responses [5,8]. However, high intensity (ISPTA >100 W/cm 2 ) and high pressure (>10 MPa) focused ultrasound indiscriminately destroys healthy tissue as well as tumors [9,10].…”

The Effect of Radiotherapy on Ultrasound-Guided Fine Needle Aspiration Biopsy and the Ultrasound Characteristics of Neck Lymph Nodes in Oral Cancer Patients after Primary Treatment

“…The thermal and mechanical effects can cause coagulative necrosis of the tumor. It is reported to facilitate treatment of prostate cancer, gastric cancer, pancreatic cancer, and hepatocellular carcinoma [ 26 – 29 ]. Additionally, high-intensity focused US could not only cause coagulation necrosis but also enhance apoptosis and growth inhibition in SCC xenograft models [ 30 , 31 ].…”

US-guided percutaneous laser ablation of refractory metastatic retroperitoneal lesions

“…[1–5] Recently, many ablation therapies for abdominal metastatic tumors were used such as radiofrequency ablation (RFA), [6,7] microwave ablation (MWA), [8,9] cryoablation, [10] irreversible electroporation (IRE), [11] and high-intensity focused ultrasound (HIFU). [12,13] Retroperitoneal deep tumors from hepatic, colorectal, renal, prostate, and ovarian carcinomas have important structures like the gastrointestinal tract and large blood vessels around, which may challenge excision, and easily induce serious complications like hemorrhage, intestinal adhesion, and even death after injury. Chemotherapy or radiotherapy could be used but sometimes the tumors are not susceptible to these treatments, in which patients may not accept the procedures.…”