Long-Term Outcome of High-Intensity Focused Ultrasound in Advanced Pancreatic Cancer

Abstract

High-intensity focused ultrasound is safe and effective, which induced excellent local tumor control in most patients with advanced PC.

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

“…In remaining studies, HIFU was used as adjuvant treatment to RT or systemic CHT. In advanced pancreatic cancer, HIFU could provide significant relief of cancer pain (56)(57)(58)(62)(63)(64) and significant improvement of the Karnofski performance score (KPS) (21,64).…”

“…Forty-four studies reported on the clinical use of HIFU (7,(10)(11)(12)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) to treat liver lesions , while 19 series were found on HIFU treatment for pancreatic cancers (6,(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73) and 4 studies included patients suffering from both liver and pancreatic cancers (74)(75)(76)(77), reporting on a total of 1,682 and 823 cases for the liver and pancreas, respectively. However, the real number of patients who benefited from HIFU treatment is much larger, since a recent review article from Zhou reported on over 3,000 cases of advanced pancreatic cancer treated with HIFU alone or in combination with chemotherapy (CHT) or radiotherapy (RT) (78).…”

“…The most frequent complications were skin burns at the application sites and osteonecrosis of ribs or vertebra along the US pathway ( Tables 5,6). Post-HIFU pain was not assessed systematically and was reported in 17 studies (384 patients undergoing liver HIFU procedures) (7,12,(19)(20)(21)(22)24,26,28,29,32,39,41,45,49,54,75) and 6 studies (62 patients receiving HIFU for pancreatic malignancies) (56,59,62,70,71,75). In only a few of those trials, a semi-quantitative evaluation tool was used to report pain level, based on the analgesic requirements (mild = no analgesic; moderate = non-steroidal anti-inflammatory drugs; severe = required morphine) (7,19,20,24,39).…”

“…Pancreatitis (biological or clinical symptoms) (n=34) (6,56,62,(70)(71)(72)75) Post-HIFU reactive pleural effusion in absence of artificial pleural infusion (n=15) (21,24,45) Cholecystitis (n=4) (24,75) Biliary tract obstructions (n=2) (26,75) Renal impairement and hematuria (n=9) (24,38) Supraventricular tachycardia (n=5), hypertension (n=8) (24) Liver abscess (n=2) (34,38) HIFU, high intensity focused ultrasound.…”

Ultrasound Ablation in Advanced Pancreatic Cancer Patients – What should be the Next Step?

“…4 From 2003 to 2014, series of studies have been published regarding Asian patients with advanced PC who were treated by US-guided HIFU (USgHIFU) with good clinical results. [4][5][6] Despite the great number of Asian studies, there are only a few cases with Caucasian patients. 7,8 All of these studies showed that USgHIFU ablation is a feasible, safe and effective treatment for pancreatic cancer with a crucial clinical benefit for the patients in terms of reduction of tumor volume and pain intensity.…”