Abstract
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.
Highlights
Pancreas is an essential gland organ in the digestive and endocrine system, producing hormones into the bloodstream and secreting pancreatic juice to the small intestine or gut
Radiofrequency ablation (RFA), percutaneous ethanol injection, cryoablation, microwave ablation, and laser-induced interstitial thermotherapy have been used widely to induce coagulative necrosis for various solid tumors, it remains difficult to use them to manage those in difficult locations, such as pancreatic malignancies
radiofrequency ablation (RFA) was used for coagulation of unresectable pancreatic cancer, but two patients died from severe complications in 20 treated cases [6]
Summary
Pancreas is an essential gland organ in the digestive and endocrine system, producing hormones (i.e., insulin, glucagon, and somatostatin) into the bloodstream and secreting pancreatic juice to the small intestine or gut. 338,000 new cases were diagnosed in 2012, and the estimated 5-year prevalence of pancreatic cancer is 4.1 per 100,000 in the world. Gemcitabine is the gold standard drug for advanced pancreatic cancer; its clinical benefit response (CBR) is 12 to 23.8%, and the median survival is only prolonged by a further 10 days. Overall 1-, 3-, and 5-year survival of pancreatic cancer patients are 16%, 5%, and 4%, respectively [5]. Most pancreatic cancer patients have severe abdominal pain and significantly decreased quality of life, which is mainly owing to the proximity of the pancreas to the duodenum, liver, stomach, jejunum, and transverse colon. Pain relief for advanced pancreatic cancer patients to enhance their quality of life is an ongoing challenge. RFA was used for coagulation of unresectable pancreatic cancer, but two patients died from severe complications in 20 treated cases [6]
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