In the past decade, HIFU ablation has emerged as a modality for palliative treatment of pancreatic tumors. Multiple preclinical and non-randomized clinical trials. HIFU appears to be an effective tool for pain palliation in advanced pancreatic cancer. Studies assessing treatment in patients with pancreatic. Request PDF on ResearchGate | HIFU for Palliative Treatment of Pancreatic Cancer | High intensity focused ultrasound (HIFU) is a novel.
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Possible explanation for the earlier effect and low energy during HIFU ablation is the very close distance between the deepest layer of the tumor and the skin surface which is only 5. Clinical results from China suggests that HIFU may be an alternative treatment for patients with locally advanced disease [ 913141617181920212223 ]. This improved immune response is probably due to the exposure of more antigens in the tumor.
The center hole in the transducer is for the ultrasound imaging probe. The first line therapy in the management of ot in patients with pancreatic cancer is the use of analgesic medications including narcotics. Current status of HIFU and cryotherapy in prostate cancer–a review. Radiation force and streaming Radiation force is exerted on an object when a wave is either absorbed or reflected from that object. The safety of Hfiu is of critical importance in the palliation of advanced pancreatic cancer.
Ultrasound imaging used in current clinical devices does not have the capability of fo thermometry, but it provides real-time imaging using the same energy modality as HIFU. Therefore, HIFU frequency should be chosen appropriately for smaller and shallower targets or larger targets located deeper within the body. A CT scan made before high intensity focused ultrasound demonstrating a tumor in the head of the pancreas.
As the lesion evolves the cells degenerate resulting in coagulative necrosis; however, this effect is significant for the treatment of the pancreas where cell lysis has potential to release autodigestive enzymes and lead to pancreatitis.
Histopathological features of liver damage induced by laser ablation in rabbits. This oscillatory motion causes microstreaming around the bubbles and that, in turn, leads to additional tissue heating through viscous friction, which can lead to coagulative necrosis. Patients were also allowed to continue chemotherapy or radiation therapy while undergoing HIFU therapy. In order to relieve the symptoms and provide better quality of life, palliative procedures and chemotherapy are usually offered to patients who are not appropriate for curative surgery.
Therefore, it is critical to evacuate the gas in the stomach and colon if possible. The median survival in these groups is about 10 and 6 months, respectively [ 1 ].
HIFU for palliative treatment of pancreatic cancer
Treatment was carefully monitored with US guide and finished when the lesion showed a large part of coagulation necrosis in the tor. The patient was evaluated at a high risk of venous thromboembolism during the following HIFU procedure due to the advanced oncological disease and chemotherapy [ 11 ].
A majority of patients diagnosed with pancreatic cancer have advanced disease at the time of diagnosis and are not amenable for surgery with intent to cure. The lesion shape becomes irregular, generally resembling a tadpole, as illustrated in Figure 3B. The patient was considered suitable for HIFU ablation with an intended palliative outcome.
In the earliest study the pancreata of 12 common swine were successfully treated in vivo using the FEP-BY02 device, without any significant adverse effects such as skin burns or evidence for pancreatitis during the 7-day post-treatment observation period The most common palliative locoregional treatment used in pancreatic ccancer is external radiotherapy RT. However, in our case multimodalities — interventional, physical destruction of primary tumor by HIFU and systemic teatment together, affect all the three aspects.
Clin Med J Treatemnt.
HIFU for palliative treatment of pancreatic cancer.
The acesodyne effect of high intensity focused ultrasound on the treatment of advanced pancreatic carcinoma. The focal characteristics of most clinically available transducers are similar to a grain of rice.
According to our case report, HIFU should be included in the multidisciplinary discussion of symptomatic patients with metastatic pancreatic cancer, i. A minority of patients are resistant and local treatments are usually considered. Contrast enhanced-CT scan of a year-old female demonstrating a hifi in the body of the pancreas prior to high intensity focused cqncer therapy a. It is worth mentioning here that ultrasound absorption in tissue increases nearly linearly with ultrasound frequency; hence, more heating occurs at higher frequencies.
Extracorporeal ablation of uterine fibroids with high-intensity focused ultrasound: Generally more often alcohol neurolysis or external radiotherapy are considered [ 16 ]. Cavitation pancreaticc also promote heating if longer HIFU pulses or continuous ultrasound is used 30 – Survivals were evaluated by means of the Kaplan-Meir method.
In the last years a number of studies have stated that HIFU can successfully and safely be used as a pain control method in PC patients [ 78 ].
High intensity focused ultrasound HIFU ablation is a non-invasive method of ablation therapy using focused ultrasound energy from an extracorporeal source that is targeted within the body resulting in thermally induced necrosis and apoptosis [ 67pancreatjc ]. Proc 4 th International Symposium on Therapeutic Ultrasound.
Newer and more promising regimens containing 5-fluorouracil 5-FU are under investigation.
The animals were not bearing tumors in the pancreas, therefore, it was not possible to evaluate survival benefits of HIFU treatmdnt however, the main goal of these studies was to systematically evaluate the safety and efficacy of HIFU ablation of the pancreas. C A lesion containing liquefied tissue may be produced by very short, high-amplitude nonlinear HIFU pulses. Tissue can be represented as viscous fluid contained by membranes.
Pancreatic cancer PC is one of the most aggressive malignant diseases which survival rate has not improved in the treatmnet 40 years. The patient is still alive at the time of the case report September ,with good quality of life without data for progression of the disease.
As a result, tissue is heated much faster than it would if nonlinear effects did not occur. Other than improving global QoL, it can also improve the tolerability of chemotherapy, the compliance of the patient to antitumour therapy thereby making systemic chemotherapy more feasible. Furthermore, it can be easily combined with palliatkve chemotherapy.
The QLQ-Pan26 is specific for the pancreatic cancer patient. Improving palliative care in this clinical context means increasing the possibility that od receiving more lines of systemic chemotherapy and possibly they could obtain an improvement of both QoL and mood, although this has not yet been demonstrated in pancreatic cancer [ 17 ]. The mechanism for pain relief in these patients may be related to damage of pain fibers innervating the tumor by HIFU without causing necrosis of the tumor.
Treatmdnt was not administered to any of the patients.