Long-Term Outcome of High-Intensity Focused Ultrasound in... : Pancreas (original) (raw)

Original Articles

Long-Term Outcome of High-Intensity Focused Ultrasound in Advanced Pancreatic Cancer

Sung, Hye Young MD, PhD*†; Jung, Seung Eun MD, PhD‡; Cho, Se Hyun MD, PhD*; Zhou, Kun MD, PhD§; Han, Joon-Yeol MD, PhD*; Han, Sung Tai MD, PhD‡; Kim, Jin Il MD, PhD*; Kim, Jae Kwang MD, PhD*; Choi, Jong Young MD, PhD*; Yoon, Seung Kew MD, PhD*; Yang, Jin Mo MD, PhD*; Han, Chi Wha MD, PhD∥; Lee, Young Sok MD, PhD*

From the *Department of Internal Medicine, Division of Gastroenterology, †Health Promotion Center of Seoul, and ‡Department of Radiology, St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea; §Clinical Center for Tumor Therapy, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China; and ∥Department of Internal Medicine, Division of Oncology, St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.

Received for publication February 2, 2010; accepted March 18, 2011.

Reprints: Se Hyun Cho, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, The Catholic University of Korea, #62, St Mary's Hospital, Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713, Korea (e-mail: [email protected]).

Drs Sung and Jung commonly attributed in this work.

The authors declare that they have no competing interests.

Authors' contributions: Drs Sung and Cho conceived and coordinated the study, analyzed the data, and drafted the initial manuscript. All authors were involved in the initial literature search and collection of data. Review of initial manuscript for major intellectual content was carried out by Drs Sung and Cho. All authors read and approved the final manuscript.

Abstract

Objectives:

The aim of this study was to evaluate safety and efficacy of high-intensity focused ultrasound (HIFU) for advanced pancreatic cancer (PC).

Methods:

Patients with PC TNM stage III or IV were included. Magnetic resonance imaging was performed 2 weeks before and after the HIFU. The ablating tumor volume was calculated by ratio of the nonperfused necrotic area of the planned area on contrast-enhanced T1-weighted image on post-HIFU magnetic resonance imaging. The ablation results were stratified into 4 ranges: 100% to 90% unenhanced area of targeting area, 90% to 50%, within 50%, and no change.

Results:

High-intensity focused ultrasound treatment was performed without severe adverse event in 46 patients, 49 times (male-female = 25:21; mean age, 60.7 ± 10.0; TNM stage 3-stage 4 = 18:28). Average size of the PC lesion was 4.2 ± 1.4 cm (1.6-9.3 cm). After HIFU treatment, ablating tumor volume was as follows: 90% to 100% in 38 lesions, 90% to 50% in 8, and within 50% in 3. Overall median survival (S1) from initial PC diagnosis was 12.4 months. Overall survival (S2) rates at 6, 12, and 18 months from HIFU were 52.2%, 30.4%, and 21.79%, respectively, with a median survival of 7.0 months

Conclusions:

High-intensity focused ultrasound is safe and effective, which induced excellent local tumor control in most patients with advanced PC.