US-guided high-intensity focused ultrasound (HIFU) of abdominal tumors: outcome, early ablation-related laboratory changes and inflammatory reaction. A single-center experience from Germany

Abstract

Marinova (2021) US-guided high-intensity focused ultrasound (HIFU) of abdominal tumors: outcome, early ablation-related laboratory changes and inflammatory reaction. A single-center experience from Germany,

Latest Advances in the Use of Therapeutic Focused Ultrasound in the Treatment of Pancreatic Cancer

“…The system consisted of a treatment table with an integrated high power focused US-therapy transducer (diameter 20 cm, focal length 15 cm, frequency 0.8 MHz), Significant reduction in tumour volumes of patients were seen from 6 weeks to 12 months after thermal ablation, as was acute induction of inflammation, including an increase in leukocytes 2, 5 and 20 h after thermal ablation, compared to baseline. Furthermore, non-statistically significant increases in IL-6 compared to baseline were seen 20 h after ablation (parameters: Treatment time = 124 ± 46 min, Sonication time = 932 ± 374 s, Energy = 343.9 ± 156.2 kJ, Power = 366 ± 91 W, Energy/Volume = 12.8 ± 4.5 kJ/mL) [203]. In a case study of a 48-year-old patient with unresectable metastatic pancreatic cancer, they were given "thermal" HIFU with the JC HIFU system as a palliative therapy after poor response to gemcitabine/erlotinib and subsequently to FOLFOX (folinic acid, oxaliplatin and 5-FU).…”

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“…After HE and immunohistochemical analysis of axillary lymph nodes, HIFU was observed to stimulate the immune responses of the whole body and significantly increase the number of effector T cells, activated CTLs, and NK cells. [124] Although many benign tumors can be treated with HIFU, [123] the coagulation necrosis caused by thermal effect is unsatisfactory in inducing immune responses. [125][126][127] To address it, combined therapy with other treatment methods is highlighted to magnify ablation outcomes for potentiating the immune responses after HIFU treatment.…”

“…Although many benign tumors can be treated with HIFU, [ 123 ] the coagulation necrosis caused by thermal effect is unsatisfactory in inducing immune responses. [ 125 , 126 , 127 ] To address it, combined therapy with other treatment methods is highlighted to magnify ablation outcomes for potentiating the immune responses after HIFU treatment.…”

“…These results indicated that the early inflammatory environment of the whole body caused by HIFU treatment was the precondition for anti‐tumor immunity. [ 123 ] In a research hosted by Zhu et al., 25 of 48 breast cancer patients underwent a modified radical mastectomy and another 23 patients underwent HIFU radical resection. After HE and immunohistochemical analysis of axillary lymph nodes, HIFU was observed to stimulate the immune responses of the whole body and significantly increase the number of effector T cells, activated CTLs, and NK cells.…”

Pancreatic Ductal Adenocarcinoma: Current and Emerging Therapeutic Uses of Focused Ultrasound

“…In the pancreas, an early study using thermal ablation reported modulation of the immune response [ 103 ]. More recently, a retrospective study also reported immunomodulation and reduced tumor volume after a one-year follow-up subsequently to HIFU thermal ablation [ 110 ]. More anecdotally, two case studies reported abscopal effects following thermal ablation [ 111 , 112 ].…”