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High-intensity focused ultrasound (HIFU) for pancreatic carcinoma: evaluation of feasibility, reduction of tumour volume and pain intensity

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Prognosis of patients with locally advanced pancreatic adenocarcinoma is extremely poor. They often suffer from cancer-related pain reducing their quality of life. This prospective observational study aimed to evaluate feasibility, local tumour response, and changes in quality of life and symptoms in Caucasian patients with locally advanced pancreatic cancer treated by ultrasound-guided high-intensity focused ultrasound (HIFU).

Methods

Thirteen patients underwent HIFU, five with stage III, eight with stage IV UICC disease. Ten patients received simultaneous palliative chemotherapy. Postinterventional clinical assessment included evaluation of quality of life and symptom changes using standardized questionnaires. CT and MRI follow-up evaluated the local tumour response.

Results

HIFU was successfully performed in all patients. Average tumour reduction was 34.2 % at 6 weeks and 63.9 % at 3 months. Complete or partial relief of cancer-related pain was achieved in 10 patients (77 %), five of whom required less analgesics for pain control. Quality of life was improved revealing increased global health status and alleviated symptoms. HIFU treatment was well tolerated. Eight patients experienced transient abdominal pain directly after HIFU.

Conclusions

HIFU ablation of pancreatic carcinoma is a feasible, safe and effective treatment with a crucial benefit in terms of reduction of tumour volume and pain intensity.

Key Points

• US-guided HIFU is feasible and safe for patients with unresectable pancreatic cancer.

• HIFU can considerably reduce tumour volume and cancer-related pain.

• Patients treated with HIFU experienced significant and lasting reduction of pain intensity.

• HIFU has a crucial clinical benefit for patients with pancreatic cancer.

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Acknowledgments

The authors acknowledge Olga Ramig and Ingrid Manderla-Franke for their skilful assistance and support. The scientific guarantor of this publication is Milka Marinova, PhD, MD. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Guido Lüchters and Dr. Rolf Fimmers kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Medical School & Hospital, University of Bonn, Siegmund-Freud-Str. 25, D-53105, Bonn, Germany

    Milka Marinova, Maximilian Rauch, Jana Henseler, Hans H. Schild & Holger M. Strunk

  2. Department of Palliative Medicine, Medical School & Hospital, University of Bonn, Bonn, Germany

    Martin Mücke, Henning Cuhls & Lukas Radbruch

  3. Department of General Practice and Family Medicine, Medical School & Hospital, University of Bonn, Bonn, Germany

    Martin Mücke

  4. Department of Palliative Medicine, Medical Faculty RWTH Aachen University, Aachen, Germany

    Roman Rolke

  5. Department of Internal Medicine I, Medical School & Hospital, University of Bonn, Bonn, Germany

    Maria A. Gonzalez-Carmona & Christian P. Strassburg

  6. Clinical Center of Tumor Therapy Chongqing, Chongqing, China

    Lian Zhang

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  1. Milka Marinova
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Correspondence to Milka Marinova.

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Marinova, M., Rauch, M., Mücke, M. et al. High-intensity focused ultrasound (HIFU) for pancreatic carcinoma: evaluation of feasibility, reduction of tumour volume and pain intensity. Eur Radiol 26, 4047–4056 (2016). https://doi.org/10.1007/s00330-016-4239-0

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  • DOI: https://doi.org/10.1007/s00330-016-4239-0

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