The efficacy of a new high intensity focused ultrasound therapy for locally advanced pancreatic cancer

Zhao, Jing; Zhao, Fu-Jun; Shi, Yulan; Deng, Yongchuan; Hu, Xiaoye; Shen, Hong

doi:10.1007/s00432-017-2459-6

Cited by 30 publications

(26 citation statements)

References 21 publications

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“…There were fewer complications and side effects after tumor lesion ablation in the present study compared with previous reports (14,28,33,34,39,40). Meanwhile, no notable clinical symptoms and manifestations of mesenteric vascular occlusion, such as persistent abdominal pain and peritoneal irritation, were observed.…”

Section: Discussioncontrasting

confidence: 52%

“…It was first reported in 2000 that HIFU successfully ablates and treats pancreatic cancer (29). Several studies have confirmed the safety and efficacy of HIFU in the treatment of pancreatic cancer (10,(14)(15)(16)(19)(20)(21)(22)(23)(24)(25)(29)(30)(31)(32)(33)(34). The most common complications observed following HIFU treatment of pancreatic cancer include skin burns (10,15,17,(21)(22)(23)(30)(31)(32), pancreatitis (10,18,23,31,32), duodenal fistula (23,31) and obstructive jaundice (19,34).…”

Section: Discussionmentioning

confidence: 99%

“…In related studies, patients with pancreatic cancer received RFA and IRE and the primary complications included acute pancreatitis (8,9,(42)(43)(44)(45)(46)48), abdominal pain (46,48), pancreatic fistula (8,9,42,43,45,49), duodenal ulcer or perforation (9,(42)(43)(44)49), gastrointestinal bleeding (42,(44)(45)(46)(47) and biliary fistula (46). In HIFU, the main complications included acute pancreatitis, skin burn, abdominal pain (22,33,34) and elevated amylase expression levels (14,21,33,34), whereas vascular adverse events are rarely recorded and patients can recover and be discharged within a short time (24,25). In addition, HIFU treatment utilizes ultrasound without involving the use of needles, electrodes, probes or similar items, therefore HIFU is safer and less invasive compared with other local ablation methods and can be performed in patients with tumors near vessels, the intestine or the bile duct stent (7).…”

Section: 12mentioning

confidence: 99%

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Effects of high‑intensity focused ultrasound treatment on peripancreatic arterial and venous blood vessels in pancreatic cancer

et al. 2020

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The present study aimed to evaluate the safety of high-intensity focused ultrasound (HIFU) treatment on peripancreatic arterial and venous blood vessels in patients with pancreatic cancer. This trial included 15 patients with pancreatic cancer (9 females and 6 males; age, 39-81 years; median age, 62 years). All patients underwent preoperative computed tomography (CT) or magnetic resonance imaging (MRI) and color Doppler flow imaging (CDFI) to assess the vascular hemodynamics of peripancreatic arterial and venous blood vessels pre-treatment. These patients were re-examined within 1 week post-HIFU treatment. Then, vascular adverse events were observed and followed up clinically. Prior to HIFU treatment, vessel involvement was recorded in 13 patients, including tumor lesions invading 19 veins and 14 arteries, which refers to the growth of pancreatic tumor lesions surrounding blood vessels, or tumor growth into blood vessels. In addition, 9 veins and 13 arteries were <1 cm from the lesions. The hemodynamic parameters of peripancreatic vessels were measured using CDFI, including mean blood flow velocity, peak systolic blood flow velocity, vascular resistance index, vascular pulsatility index, vascular diameter, vascular blood flow and other indicators, to assess vascular perfusion in CT/MRI. There were no significant differences in preoperative and postoperative hemodynamic data (P>0.05). Overall, HIFU demonstrated no negative effects on peripancreatic arterial and venous blood vessels in patients with pancreatic cancer, even with tumor lesions wrapped in blood vessels. In addition, no complications of vascular stenosis and vascular adverse events were observed in the present study.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: 12mentioning

confidence: 99%

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Effects of high‑intensity focused ultrasound treatment on peripancreatic arterial and venous blood vessels in pancreatic cancer

et al. 2020

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“…19,20 A minimally invasive treatment, HIFU can be used alone or in combination with chemotherapy to safely and effectively treat patients with advanced PC. [21][22][23][24][25] Results from a meta-analysis showed that approximately 80% of patients with advanced PC who received HIFU therapy experienced pain reduction. 26 Ji et al 27 also reported that HIFU treatment was effective and the adverse events (AEs) associated with the treatment were rare and tolerable, especially for old patients and those with poor performance status.…”

Section: Discussionmentioning

confidence: 99%

<p>High-intensity focused ultrasound enhances the effect of bufalin by inducing apoptosis in pancreatic cancer cells</p>

Ning

Zhu

Zhang

et al. 2019

OTT

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High-intensity focused ultrasound (HIFU) has the potential to be an effective therapeutic strategy for pancreatic cancer (PC). However, owing to the high malignancy and poor prognosis of PC, the use of HIFU therapy alone is not sufficient to impair the progression of PC. Bufalin, a compound extracted from traditional medicine, is known to inhibit the growth and progression of PC cells. However, the effect of the combination therapy of HIFU plus bufalin (HIFU+bufalin) is still uncertain. Materials and methods: A colony formation assay and flow cytometry were performed to measure the growth and induction of apoptosis in PC cells. Western blotting was used to explore the potential mechanism of HIFU and bufalin therapy. The in vivo efficacy of HIFU+bufalin was tested in a MiaPaCa 2 xenograft model. Results: Bufalin inhibited the growth of PC cells more obviously compared to HIFU. Combining bufalin with HIFU further decreased the growth of MiaPaCa 2 cells compared with single therapy in vitro. Flow cytometry results showed that the percentage of surviving MiaPaCa 2 cells in the bufalin-treated group and the HIFU-treated group was approximately threefold and twofold higher than in the HIFU+bufalin-treated group. Contrasting results were found in Panc-1 cells. Biochemical analysis revealed that HIFU+bufalin treatment elevated PARP expression and increased caspase-8 activation in MiaPaCa 2 and Panc-1 cells. HIFU+bufalin significantly reduced the growth of MiaPaCa 2 tumors compared with HIFU or bufalin treatment alone. HIFU+bufalin treatment decreased Ki67 staining and increased activated caspase-3 and caspase 8 staining, when compared with HIFU or bufalin treatment alone in mouse tumors. Conclusion: HIFU enhanced the effect of bufailn by inducing apoptosis in PC cells. A combination of HIFU and bufalin may be employed as an alternative therapeutic strategy for PC.

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“…A recent, moderately powered (n=689) retrospective analysis from China revealed an independent median overall survival benefit from ablative FUS treatment for patients with unresectable PDA who also received a variety of multi-modal treatment regimens, without severe adverse events (7.1 versus 5 months; p=0.005) [112]. A smaller retrospective series (n=38) from China found that an ablative FUS protocol with prolonged lower-power heat deposition had a greater median overall survival benefit versus a rapid heating protocol (10.3 versus 6.0 months; p=0.018) [113]. A small number of randomized clinical trials have examined the survival benefit of ablative FUS therapy.…”

Section: Introductionmentioning

confidence: 99%

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

Maloney

Khokhlova

Pillarisetty

et al. 2017

International Reviews of Immunology

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Current clinical treatment regimens, including many emergent immune strategies (e.g. checkpoint inhibitors) have done little to affect the devastating course of pancreatic ductal adenocarcinoma (PDA). Clinical trials for PDA often employ multi-modal treatment, and have started to incorporate stromal-targeted therapies, which have shown promising results in early reports. Focused ultrasound (FUS) is one such therapy that is uniquely equipped to address local and systemic limitations of conventional cancer therapies as well as emergent immune therapies for PDA. FUS methods can non-invasively generate mechanical and/or thermal effects that capitalize on the unique oncogenomic/proteomic signature of a tumor. Potential benefits of FUS therapy for PDA include: 1) emulsification of targeted tumor into undenatured antigens in situ, increasing dendritic cell maturation, and increasing intra-tumoral CD8+/ T regulatory cell ratio and CD8+ T cell activity; 2) reduction in intra-tumoral hypoxic stress; 3) modulation of tumor cell membrane protein localization to enhance immunogenicity; 4) modulation of the local cytokine milieu toward a Th1-type inflammatory profile; 5) up-regulation of local chemoattractants; 6) remodeling the tumor stroma; 7) localized delivery of exogenously packaged immune-stimulating antigens, genes and therapeutic drugs. While not all of these results have been studied in experimental PDA models to date, the principles garnered from other solid tumor and disease models have direct relevance to the design of optimal FUS protocols for PDA. In this review, we address the pertinent limitations in current and emergent immune therapies that can be improved with FUS therapy for PDA.

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The efficacy of a new high intensity focused ultrasound therapy for locally advanced pancreatic cancer

Abstract: The low power cumulative HIFU treatment showed a statistical significance in survival benefit with better safety profile compared to the traditional HIFU treatment in patients with locally advanced pancreatic cancer.

Cited by 30 publications

References 21 publications

Effects of high‑intensity focused ultrasound treatment on peripancreatic arterial and venous blood vessels in pancreatic cancer

Effects of high‑intensity focused ultrasound treatment on peripancreatic arterial and venous blood vessels in pancreatic cancer

<p>High-intensity focused ultrasound enhances the effect of bufalin by inducing apoptosis in pancreatic cancer cells</p>

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

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