Ultrasound–guided percutaneous laser ablation for pancreatic cancer: a new treatment option

Abstract

Background & purpose‎: Most patients with pancreatic cancer (PC) suffer from an unresectable tumor at the time of diagnosis with limited treatment effectiveness. The purpose of this study is to investigate the feasibility and safety of percutaneous laser ablation (LA) for locally advanced and metastatic PC.Methods: Between September 2016 and April 2018, nine patients (mean age, 65.2 ± 5.4 years; age range, 62–68 years) with histologically proved PC were prospectively included to undergo ultrasound-guided LA. Effect including safety, pain perception and survival were evaluated. Results: Three patients were with locally advanced PC (stage III) and six with metastases (stage IV). All patients underwent LA in one session. The mean largest tumor diameter was ‎5.2±0.8 ‎cm (range, 4.2-6.9cm). Ablation power of all patients was 5 W and the mean ablation energy was 8.3±2.4 KJ (range 4.4-12KJ). Mean ablation volume was 17.1±3.2ml (range 13.0-22.1ml), which reached 89.1±7.4% (range 80.2-98.0%) of tumor volume. After a median follow-up period of 9.7 months (range, 6-15 months), the median survival from diagnosis was 11.2 months. Four stage IV patients died during 6.5-12.5 months after LA because of one hepatic encephalopathy and three tumor progression. No major complications occurred. Pain symptom achieved significant remission (P < 0.001) and patients experienced ameliorative physical function after LA. Percutaneous LA for unresectable PC is generally well tolerated. Conclusions: Preliminary results are encouraging with tumor size reducing and physical function significant improvement. US-guided percutaneous LA provides a new minimally invasive therapy modality for PC.