HIFU for Palliative Treatment of Pancreatic Cancer

Khokhlova, Tatiana D.; Hwang, Joo Ha

doi:10.1007/978-3-319-22536-4_5

Cited by 55 publications

(50 citation statements)

References 74 publications

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“…For pancreatic cancer, as we could verify through our systematic review, the frequent diagnostic delay with the ineluctable poor prognosis associated with advanced stages, relegates HIFU to a mere role of co-adjuvant therapy, the best effects of which are probably linked to pain management and quality of life for patients (83). In fact, advanced pancreatic cancer often presents with severe pain which is commonly managed with morphine administration and/or celiac plexus alcoholization (84).…”

Section: Discussionmentioning

confidence: 91%

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

Diana¹,

Schiraldi²,

Liu³

et al. 2016

Hepatobiliary Surg. Nutr.

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Background: High intensity focused ultrasound (HIFU) is emerging as a valid minimally-invasive imageguided treatment of malignancies. We aimed to review to current state of the art of HIFU therapy applied to the digestive system and discuss some promising avenues of the technology.Methods: Pertinent studies were identified through PubMed and Embase search engines using the following keywords, combined in different ways: HIFU, esophagus, stomach, liver, pancreas, gallbladder, colon, rectum, and cancer. Experimental proof of the concept of endoluminal HIFU mucosa/submucosa ablation using a custom-made transducer has been obtained in vivo in the porcine model. Results:Forty-four studies reported on the clinical use of HIFU to treat liver lesions, while 19 series were found on HIFU treatment of pancreatic cancers and four studies included patients suffering from both liver and pancreatic cancers, reporting on a total of 1,682 and 823 cases for liver and pancreas, respectively. Only very limited comparative prospective studies have been reported. Conclusions:Digestive system clinical applications of HIFU are limited to pancreatic and liver cancer. It is safe and well tolerated. The exact place in the hepatocellular carcinoma (HCC) management algorithm remains to be defined. HIFU seems to add clear survival advantages over trans arterial chemo embolization (TACE) alone and similar results when compared to radio frequency (RF). For pancreatic cancer, HIFU achieves consistent cancer-related pain relief. Further research is warranted to improve targeting accuracy and efficacy monitoring. Furthermore, additional work is required to transfer this technology on appealing treatments such as endoscopic HIFU-based therapies.Keywords: High intensity focused ultrasound (HIFU); liver cancer; pancreatic cancer; miniature HIFU delivery system; endoluminal applications of HIFU; mucosa and submucosal ablations using HIFU

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Section: Discussionmentioning

confidence: 91%

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

Diana¹,

Schiraldi²,

Liu³

et al. 2016

Hepatobiliary Surg. Nutr.

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“…They were treated using a customized configuration of commercial clinical ultrasound scanners in the presence of MBs. The combination of ultrasound, microbubbles, and the chemotherapy in these clinical settings increased the number of treatment cycles, prolonging the quality of life in patients with pancreatic adenocarcinomas compared to chemotherapy treatment alone [147,178,[186][187][188][189][190].…”

Section: Clinical Applications Of Nps Assisted Ultrasound In Cancer Tmentioning

confidence: 99%

Nanoparticle-assisted ultrasound: A special focus on sonodynamic therapy against cancer

Canavese

Ancona

Racca

et al. 2018

Chemical Engineering Journal

353

247

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• Ultrasound-based therapies are opening new horizons in the oncological field.• Innovative and promising solutions derive from different nanoparticles-assisted ultrasound treatments.• Sonodynamic therapy (SDT) emerged recently as a novel approach for cancer treatment.• Different and complex cell death mechanisms are involved in nanoparticles-assisted SDT.• Nanoparticles-assisted ultrasound is still at its infancy in clinics. A R T I C L E I N F O Keywords:Inertial cavitation Reactive oxygen species Sonoluminescence Sonodynamic Tumor Therapy Cytotoxicity A B S T R A C TAt present, ultrasound radiation is broadly employed in medicine for both diagnostic and therapeutic purposes at various frequencies and intensities. In this review article, we focus on therapeutically-active nanoparticles (NPs) when stimulated by ultrasound. We first introduce the different ultrasound-based therapies with special attention to the techniques involved in the oncological field, then we summarize the different NPs used, ranging from soft materials, like liposomes or micro/nano-bubbles, to metal and metal oxide NPs. We therefore focus on the sonodynamic therapy and on the possible working mechanisms under debate of NPs-assisted sonodynamic treatments. We support the idea that various, complex and synergistics physical-chemical processes take place during acoustic cavitation and NP activation. Different mechanisms are therefore responsible for the final cancer cell death and strongly depends not only on the type and structure of NPs or nanocarriers, but also on the way they interact with the ultrasonic pressure waves. We conclude with a brief overview of the clinical applications of the various ultrasound therapies and the related use of NPs-assisted ultrasound in clinics, showing that this very innovative and promising approach is however still at its infancy in the clinical cancer treatment.

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“…Here, especially sonographic-guided HIFU applications have already been well established, whereas MR-HIFU approaches are now upcoming therapeutic advancements. 16,[55][56][57] Especially, targeted vessel ablation by MR-HIFU could mean an interesting approach in curative as well as palliative oncologic treatments. 58 MR-HIFU treatment of breast cancer is now in development as tumor necrosis of up to 100% has been reported.…”

Section: Discussionmentioning

confidence: 99%

MR-guided high-intensity focused ultrasound treatment of uterine fibroids

Wiggermann¹,

Beldoch²,

Hoellen³

et al. 2016

RRFU

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Uterine fibroids are benign, encapsulated uterine tumors, representing the most common reason for hysterectomy in premenopausal women. High-intensity focused ultrasound (HIFU; also known as focused ultrasound surgery) is a noninvasive technique leading to tissue heating in a centered focus, inducing a thermal tissue necrosis. Magnetic resonance-guided HIFU (MR-HIFU; also know as MR-guided focused ultrasound surgery) allows to allocate the uterine fibroids as well as to evaluate whether these are accessible for HIFU treatment. Further advantages are MR-based real-time temperature mapping and immediate evaluation of postprocedure therapeutic success by MR imaging. These advantages minimize the patient risk and make the treatment more effective. MR-HIFU is a uterus conserving, low pain-to-painless, and noninvasive treatment option. Here, we review its medical and economic advance to surgical procedures due to the low complication rates combined with proven symptom relief and the enhancement of the quality of life.

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HIFU for Palliative Treatment of Pancreatic Cancer

Cited by 55 publications

References 74 publications

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

Nanoparticle-assisted ultrasound: A special focus on sonodynamic therapy against cancer

MR-guided high-intensity focused ultrasound treatment of uterine fibroids

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