Cryosurgery in Combination with Iodine-125 Seed Brachytherapy for Pancreatic Cancer

Xu, Kecheng; Niu, Lizhi; Mu, Feng; Hu, Yue

doi:10.1142/9789814329668_0034

Cited by 6 publications

(9 citation statements)

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“…This has been known for some time from in-vitro studies [99] and was clinically confirmed also for pancreatic and lung cancer in small case series [100,101].…”

Section: Combination Therapymentioning

confidence: 61%

Current Technique and Application of Percutaneous Cryotherapy

Mahnken

König

Figiel

2018

Fortschr Röntgenstr

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ABSTR AC TPurpose Local ablative therapies have become an established treatment option in interventional oncology. Radiofrequency ablation (RFA) and microwave ablation (MWA) are a standard of care in the treatment of hepatocellular carcinoma (HCC). Currently, there is an increasing interest in cryotherapy, one of the oldest ablation techniques. It has some unique characteristics with regard to technology and mechanism of action.Materials and Methods A systematic literature search using the terms cryotherapy, cryosurgery and cryoablation was performed. Selected studies are presented dealing with the mechanism of action, cryobiology and clinical use of percutaneous, image-guided cryoablation. Recent developments and perspectives are presented.Results Cryotherapy is increasingly used and has been included in guidelines for selected tumor entities such as renal cell carcinoma. Cryo-immunotherapy and combination treatments are future areas of interest.Conclusion Cryoabalation may be used in many indications.Its major advantages are its unique visualization and the anesthesiologic effects of cold. While there are only a few prospectively randomized trials, the existing data on the use of cryoablation is promising. Its use appears to be justified in selected tumors, oligometastatic patients and for palliative indications.

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“…This has been known for some time from in-vitro studies [99] and was clinically confirmed also for pancreatic and lung cancer in small case series [100,101].…”

Section: Combination Therapymentioning

confidence: 61%

Current Technique and Application of Percutaneous Cryotherapy

Mahnken

König

Figiel

2018

Fortschr Röntgenstr

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“…To date, four articles have been published on the use of cryoablation in the context of LAPC, two in an open [61,62] and two in a percutaneous setting [12,63]. As monotherapy, cryoablation demonstrated a mOS of 12.6 months [63], and in combination with internal radiotherapy a mOS of 16.2 months [12] was noted (neither article specified whether OS from diagnosis or treatment). Niu et al were the only group reporting on sole percutaneous cryoablation and included patients with stage II (n = 3), III (n = 11), and IV (n = 18) PDAC whose tumor was deemed unresectable [63].…”

Section: Efficacy and Safety Of Cryoablationmentioning

confidence: 99%

“…all stages). In order to overcome potentially incomplete destruction at the ablation border, Xu et al described percutaneous cryoablation in combination with brachytherapy in LAPC (n = 49), demonstrating a mOS of 16.2 months with a 6% severe complication rate [12]. The freezing process can injure delicate parenchyma including the duodenum, bile ducts, or blood vessels, resulting in inflammation, fistulas, abscesses, or bleeding.…”

Section: Efficacy and Safety Of Cryoablationmentioning

confidence: 99%

“…As with the other local therapies, implantation can be accomplished through open [90][91][92][93][94] or percutaneous [8,12,27,28] means under CT or US guidance, with the latter approach having shorter procedural times and quicker recovery [95].…”

Section: Brachytherapy: Iodine-125 Seed Implantationmentioning

confidence: 99%

“…As stand-alone local therapy, median survival outcomes in LAPC patients percutaneously treated ranges between 7.3 and 11 months. Additional increase in survival can be achieved if 125 I seed implantation is combined with other interventional modalities such as cryoablation (mOS 16.2 months) [12] or TACE (mOS 17.6 months) [8]. Reported severe morbidity varies between 0 and17% (vs. 0-11% open setting), whereas mortality among studies was 0% (vs. 1.3% open setting).…”

Section: Safety and Efficacy Of 125 I Seed Implantationmentioning

confidence: 99%

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Locally Advanced Pancreatic Cancer: Percutaneous Management Using Ablation, Brachytherapy, Intra-arterial Chemotherapy, and Intra-tumoral Immunotherapy

et al. 2021

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Purpose of Review Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive neoplasms, bearing a terrible prognosis. Stage III tumors, also known as locally advanced pancreatic cancer (LAPC), are unresectable, and current palliative chemotherapy regimens have only modestly improved survival in these patients. At this stage of disease, interventional techniques may be of value and further prolong life. The aim of this review was to explore current literature on locoregional percutaneous management for LAPC. Recent Findings Locoregional percutaneous interventional techniques such as ablation, brachytherapy, and intra-arterial chemotherapy possess cytoreductive abilities and have the potential to increase survival. In addition, recent research demonstrates the immunomodulatory capacities of these treatments. This immune response may be leveraged by combining the interventional techniques with intra-tumoral immunotherapy, possibly creating a durable anti-tumor effect. This multimodality treatment approach is currently being examined in several ongoing clinical trials. Summary The use of certain interventional techniques appears to improve survival in LAPC patients and may work synergistically when combined with immunotherapy. However, definitive conclusions can only be made when large prospective (randomized controlled) trials confirm these results.

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