Concurrent Chemotherapy and Pulsed High-Intensity Focused Ultrasound Therapy for the Treatment of Unresectable Pancreatic Cancer: Initial Experiences

Abstract

ObjectiveThis study was performed to evaluate the potential clinical value of concurrent chemotherapy and pulsed high intensity focused ultrasound (HIFU) therapy (CCHT), as well as the safety of pulsed HIFU, for the treatment of unresectable pancreatic cancer.Materials and MethodsTwelve patients were treated with HIFU from October 2008 to May 2010, and three of them underwent CCHT as the main treatment (the CCHT group). The overall survival (OS), the time to tumor progression (TTP), the complications and the current performance status in the CCHT and non-CCHT groups were analyzed. Nine patients in the non-CCHT group were evaluated to determine why CCHT could not be performed more than twice.ResultsThe OS of the three patients in the CCHT group was 26.0, 21.6 and 10.8 months, respectively, from the time of diagnosis. Two of them were alive at the time of preparing this manuscript with an excellent performance status, and one of them underwent a surgical resection one year after the initiation of CCHT. The TTP of the three patients in the CCHT group was 13.4, 11.5 and 9.9 months, respectively. The median OS and TTP of the non-CCHT group were 10.3 months and 4.4 months, respectively. The main reasons why the nine patients of the non-CCHT group failed to undergo CCHT more than twice were as follows: pancreatitis (n = 1), intolerance of the pain during treatment (n = 4), palliative use of HIFU for pain relief (n = 1) and a poor physical condition due to disease progression (n = 3). No major complications were encountered except one case of pancreatitis.ConclusionThis study shows that CCHT is a potentially effective and safe modality for the treatment of unresectable pancreatic cancer.

Focused ultrasound for immuno-adjuvant treatment of pancreatic cancer: An emerging clinical paradigm in the era of personalized oncotherapy

“…Similar effects have been observed by others [114, 130–132]. In all cases, patients received systemic chemotherapy concurrently with FUS treatments, but chemotherapy had been ineffective prior to initiation of FUS therapy.…”

Ultrasound Guided High Intensity Focused Ultrasound for malignant tumors: The Spanish experience of survival advantage in stage III and IV pancreatic cancer

“…Recently, several papers have reported the successful use of HIFU for pancreas tumors [3][4][5][6]. Anatomical locations of these types of lesions preclude the use of minimally-invasive procedures such as radiofrequency, microwaves, cryotherapy, ethanol injection, or embolisation procedures but allow the treatment with HIFU.…”

Enhancement of Small Molecule Delivery by Pulsed High-Intensity Focused Ultrasound: A Parameter Exploration

“…Initial trials of HIFU ablation of unresectable pancreatic cancer during chemotherapy showed higher survival and longer time to tumor progression than chemotherapy alone (19.5 vs. 10.3 months and 11.6 vs. 4.4 months respectively). No major complications were reported (Lee et al 2011). Our study suggests that such enhanced drug delivery depends on the HIFU parameters used.…”