High Intensity Focused Ultrasound Ablation for Patients With Locally Advanced Pancreatic Adenocarcinoma: A Propensity Score‐Matching Analysis

Abstract

Objectives-This retrospective study was conducted to assess the efficacy and safety of high intensity focused ultrasound (HIFU) in combination with chemotherapy compared with chemotherapy alone in treating patients with unresectable locally advanced pancreatic cancer (LAPC).Methods-The data of unresectable LAPC patients who received chemotherapy with or without HIFU ablation were retrieved retrospectively. The overall survival (OS), objective response rate (ORR), cancer antigen 19-9 response rate, and safety were compared between these two groups before and after propensity score matching (PSM).Results-Overall, 254 patients with LAPC were included, of whom 92 underwent HIFU ablation. After PSM to control for potential biases, HIFU was associated with improved OS (12.8 versus 12.2 months, log-rank P = .046), as compared to patients without HIFU ablation. Patients with numeric rating scale (NRS) less than 4, and receiving HIFU ablation were significantly associated with improved OS (adjusted hazard ratio [aHR] = 0.365 [95% confidence interval (CI) = 0.148-0.655], P = .002; aHR = 0.490 [95% CI = 0.250-0.961], P = .038; respectively) by multivariate analyses with the adjustment of age, NRS, and tumor size. ORR was also observed to be higher in HIFU group of 30.0% than in the chemotherapy group of 13.3% (P = .039). No severe adverse events of special interest or HIFU-caused deaths were observed.Conclusions-Patients with unresectable LAPC who received gemcitabine-based chemotherapy might benefit from additional HIFU ablation.Key Words-high intensity focused ultrasound ablation; locally advanced pancreatic cancer; overall survival; propensity score matching; response rate; unresectable P ancreatic carcinoma is recognized as one of the most aggressive tumor types globally, carrying a grim long-term prognosis. It is particularly challenging to treat because it usually becomes terminal and unresectable cancer by the time the patients are diagnosed. Exceptionally few options would be available for these patients with a dismal 5-year survival rate of less than 10%. 1,2 Locally advanced pancreatic cancer (LAPC) is defined by its encasement located in the celiac axis or the superior mesenteric artery without distant metastasis. Among all the cases

Interaction Between Microbubbles and Microwave Ablation

“…High-intensity focused ultrasound (HIFU), radiofrequency ablation (RFA), and microwave ablation (MWA) are the most frequently used thermal ablation techniques in clinics. [11][12][13] Many studies have demonstrated that MBs can accelerate HIFU-induced temperature increases, enlarge the ablation region, and distort and shift the ablation position. 9,14 However, conflicting results regarding the effects of MBs on RFA have been reported.…”