scholarly journals Advanced Pancreatic Cancer: High-Intensity Focused Ultrasound (HIFU) and Other Local Ablative Therapies

2019 ◽  
Vol 191 (03) ◽  
pp. 216-227 ◽  
Author(s):  
Milka Marinova ◽  
Timo Wilhelm-Buchstab ◽  
Holger Strunk
Keyword(s):  
Pancreatic Cancer ◽  
Focused Ultrasound ◽  
Advanced Pancreatic Cancer ◽  
High Intensity Focused Ultrasound ◽  
Treatment Modalities ◽  
Mass Reduction ◽  
Local Tumor ◽  
Tumor Mass ◽  
Ablative Therapies

Background Locally advanced pancreatic cancer is a life-limiting tumor with a wide range of incapacitating symptoms such as cancer-associated pain. Several local ablative therapies with both thermal and non-thermal sources have recently received significant attention as modern treatment options for local tumor control and symptomatic improvement. The following review article provides an overview of currently available techniques and their outcomes including our own experience with high-intensity focused ultrasound (HIFU) being one of the most exciting and innovative modalities. Method Our experiences with HIFU treatment are based on 89 pancreatic cancer patients (UICC III-IV). Outcomes such as treatment-related changes in symptoms particularly in cancer pain and quality of life as well as local tumor response, safety and survival were compared to reported studies concerning HIFU, radiofrequency and microwave ablation, cryoablation, irreversible electroporation and stereotactic body radiation therapy. Results Even though all strategies appeared to be feasible, the unique feature of noninvasiveness represents a substantial advantage of the HIFU procedure. In 85 % of HIFU-treated patients, long-lasting pain relief was achieved. 50 % of patients did not require any analgesic treatment 6 weeks post-ablation. Unfortunately, pain palliation and quality-of-life outcomes are only rarely reported for other local treatment modalities. Tumor mass reduction could be achieved with all ablative therapies, with a mean tumor volume reduction of 60 % after 6 months in HIFU-treated pancreatic tumors. Differences in treatment-associated morbidity were reported. However, they are only partially comparable due to unbalanced study populations. Conclusion Various local ablative treatment modalities are available and feasible for tumor mass reduction of advanced pancreatic cancer but with different symptomatic benefit for patients. An effective and long-lasting reduction of cancer-related pain was observed following HIFU without insertion of needles or electrodes. Randomized controlled studies for head-to-head comparison of these modalities are warranted in the near future. Key points:  Citation Format

scholarly journals High-Intensity Focused Ultrasound Treatment for Advanced Pancreatic Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Yufeng Zhou
Keyword(s):  
Pancreatic Cancer ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Advanced Pancreatic Cancer ◽  
High Intensity Focused Ultrasound ◽  
Treatment Modalities ◽  
Karnofsky Performance Scale ◽  
Great Success ◽  
Hifu Treatment ◽  
Performance Scale

Pancreatic cancer is under high mortality but has few effective treatment modalities. High-intensity focused ultrasound (HIFU) is becoming an emerging approach of noninvasively ablating solid tumor in clinics. A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success. The principle, mechanism, and clinical outcome of HIFU were introduced first. All 3022 clinical cases of HIFU treatment for the advanced pancreatic cancer alone or in combination with chemotherapy or radiotherapy in 241 published papers were reviewed and summarized for its efficacy, pain relief, clinical benefit rate, survival, Karnofsky performance scale (KPS) score, changes in tumor size, occurrence of echogenicity, serum level, diagnostic assessment of outcome, and associated complications. Immune response induced by HIFU ablation may become an effective way of cancer treatment. Comments for a better outcome and current challenges of HIFU technology are also covered.

scholarly journals The Use of High-Intensity Focused Ultrasound (HIFU) Plus 150mg Bicalutamide as First Line Salvage Therapy for Local Recurrent Prostate Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Jian-zhou Cao ◽  
Rui Su ◽  
Jin-feng Pan ◽  
Ze-jun Yan ◽  
Qi Ma
Keyword(s):  
Prostate Cancer ◽  
Salvage Therapy ◽  
High Intensity ◽  
Focused Ultrasound ◽  
High Intensity Focused Ultrasound ◽  
Local Tumor ◽  
First Line ◽  
Minimal Invasiveness ◽  
Tumor Load

Patients with localized prostate cancer (PCa) are often treated with radical prostatectomy (RP). However, more than 30% of such patients have high risk of recurrence. Salvage radiotherapy (SRT), androgen deprivation therapy (ADT) and combination of radiotherapy and ADT are the standard care for recurrent PCa. Recently, high intensity focused ultrasound (HIFU) has gradually applied in the treatment of recurrent PCa. Here, we proposed a hypothesis that combined HIFU and bicalutamide 150mg as first line salvage therapy to treat patients with local recurrent PCa with visible lesions due to the following advantages: (1) HIFU is effective in reducing local tumor load, and bicalutamide 150mg is a feasible and safety option to combine with HIFU. (2) Compared with radiotherapy, HIFU plus 150mg bicalutamide is minimal invasiveness with fewer adverse effects and better quality of life(QOL); (3) Radiotherapy can be preserved as the second-line salvage method in the cases who are failure to HIFU and 150mg bicalutamide combination. More clinical trials are warranted to confirm this hypothesis in treatment with recurrent PCa.

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