Thermal Ablation of the Pancreas With Intraoperative High-Intensity Focused Ultrasound

Dupré, Aurélien; Melodelima, David; Pflieger, Hannah; Chen, Yao; Vincenot, Jérémy; Kocot, Anthony; Langonnet, Stephan; Rivoire, Michel

doi:10.1097/mpa.0000000000000720

Cited by 18 publications

(13 citation statements)

References 33 publications

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“…First, HIFU therapy has been suggested to enhance drug penetration and activate cancer-specific immunity [ 5 ]. It is also important to conduct research on the potential benefits of HIFU, such as the immunopotentiation effect, the abscopal effect, and drug (anticancer drug) penetration effect [ 2 , 4 , 7 , 54 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. Second, it has long been known that the cauterization area of HIFU is enhanced by microbubbles (enhancement of the cavitation effect) [ 70 ].…”

Section: Discussionmentioning

confidence: 99%

Novel Therapeutic Method for Unresectable Pancreatic Cancer—The Impact of the Long-Term Research in Therapeutic Effect of High-Intensity Focused Ultrasound (HIFU) Therapy

et al. 2021

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High-intensity focused ultrasound (HIFU) is a novel advanced therapy for unresectable pancreatic cancer (PC). HIFU therapy with chemotherapy is being promoted as a novel method to control local advancement by tumor ablation. We evaluated the therapeutic effects of HIFU therapy in locally advanced and metastatic PC. PC patients were treated with HIFU as an optional local therapy and systemic chemotherapy. The FEP-BY02 (Yuande Bio-Medical Engineering) HIFU device was used under ultrasound guidance. Of 176 PC patients, 89 cases were Stage III and 87 were Stage IV. The rate of complete tumor ablation was 90.3%, while that of symptom relief was 66.7%. The effectiveness on the primary lesions were as follows: complete response (CR): n = 0, partial response (PR): n = 21, stable disease (SD): n = 106, and progressive disease (PD): n = 49; the primary disease control rate was 72.2%. Eight patients underwent surgery. The median survival time (MST) after diagnosis for HIFU with chemotherapy compared to chemotherapy alone (100 patients in our hospital) was 648 vs. 288 days (p < 0.001). Compared with chemotherapy alone, the combination of HIFU therapy and chemotherapy demonstrated significant prolongation of prognosis. This study suggests that HIFU therapy has the potential to be a novel combination therapy for unresectable PC.

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Section: Discussionmentioning

confidence: 99%

Novel Therapeutic Method for Unresectable Pancreatic Cancer—The Impact of the Long-Term Research in Therapeutic Effect of High-Intensity Focused Ultrasound (HIFU) Therapy

et al. 2021

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“…Different types of energy can be used to apply heat, including ultrasound, radiofrequency, and microwave [8,17]. Ultrasound involves the propagation of sound waves at a frequency of 2 to 20 MHz through the tissue that leads to their absorption and results in regional elevated temperatures [38,39]. The high-intensity focused ultrasound (HIFU) technique allows both ablation and moderate hyperthermia of the tumor.…”

Section: Heating Modalities Used To Induce Hyperthermiamentioning

confidence: 99%

Thermosensitive Nanosystems Associated with Hyperthermia for Cancer Treatment

et al. 2019

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Conventional chemotherapy regimens have limitations due to serious adverse effects. Targeted drug delivery systems to reduce systemic toxicity are a powerful drug development platform. Encapsulation of antitumor drug(s) in thermosensitive nanocarriers is an emerging approach with a promise to improve uptake and increase therapeutic efficacy, as they can be activated by hyperthermia selectively at the tumor site. In this review, we focus on thermosensitive nanosystems associated with hyperthermia for the treatment of cancer, in preclinical and clinical use.

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“…The principal focus lies in the possibility of treating the parenchyma independently from perfusion [ 20 ] with high control of the treatment margins [ 21 ] and accurate visualization of the tumor and of HIFU ablation [ 18 , 19 , 22 , 23 ]. The intraoperative HIFU probe designed for the treatment of liver tumors has shown potential applicability for pancreatic tumors [ 24 ]. Treating LAPA with HIFU intraoperatively can also help to confirm that the tumor is not resectable (major vascular invasion precluding resection) and that liver or peritoneal metastatic spread has not occurred.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative HIFU Ablation of the Pancreas Using a Toroidal Transducer in a Porcine Model. The First Step towards a Clinical Treatment of Locally Advanced Pancreatic Cancer

Cilleros

Dupré

Chen

et al. 2021

Cancers

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Apart from palliative chemotherapy, no other therapy has been proven effective for the treatment of locally advanced pancreatic tumors. In this study, an intraoperative high-intensity focused ultrasound (HIFU) device was tested in vivo to demonstrate the feasibility of treating the pancreatic parenchyma and tissues surrounding the superior mesenteric vessels prior to clinical translation of this technique. Twenty pigs were included and treated using a HIFU device equipped with a toroidal transducer and an integrated ultrasound imaging probe. Treatments were performed with energy escalation (from 30 kJ to 52 kJ). All treatments resulted in visible (macroscopically and in ultrasound images) homogeneous thermal damage, which was confirmed by histology. The dimensions of thermal lesions measured in ultrasound images and those measured macroscopically were correlated (r = 0.82, p < 0.05). No arterial spasms or occlusion were observed at the lowest energy setting. Temporary spasm of the peripancreatic artery was observed when using an energy setting greater than 30 kJ. The possibility of treating the pancreas and tissues around mesenteric vessels without vascular thrombosis holds great promise for the treatment of locally advanced pancreatic cancers. If clinically successful, chemotherapy followed by HIFU treatment could rapidly become a novel treatment option for locally advanced pancreatic cancer.

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Thermal Ablation of the Pancreas With Intraoperative High-Intensity Focused Ultrasound

Abstract: Intraoperative thermal destruction of porcine pancreas with HIFU is feasible. Reproducibility and safety have to be confirmed when applied close to mesenteric vessels and in long-term preclinical studies.

Cited by 18 publications

References 33 publications

Novel Therapeutic Method for Unresectable Pancreatic Cancer—The Impact of the Long-Term Research in Therapeutic Effect of High-Intensity Focused Ultrasound (HIFU) Therapy

Novel Therapeutic Method for Unresectable Pancreatic Cancer—The Impact of the Long-Term Research in Therapeutic Effect of High-Intensity Focused Ultrasound (HIFU) Therapy

Thermosensitive Nanosystems Associated with Hyperthermia for Cancer Treatment

Intraoperative HIFU Ablation of the Pancreas Using a Toroidal Transducer in a Porcine Model. The First Step towards a Clinical Treatment of Locally Advanced Pancreatic Cancer

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