High-intensity focused ultrasound (HIFU) for tumor reduction and symptom relief in advanced pancreatic cancer

Purpose: Evaluation of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with inoperable pancreatic cancer to reduce tumor volume and tumor-associated pain. Material and methods: Fifteen patients with locally advanced inoperable pancreatic cancer and tumor-associated pain symptoms were treated by HIFU (n = 6 stage III, n = 9 Stage IV UICC). Thirteen patients underwent simultaneous standard chemotherapy. JC HIFU System (Chongqing, China HAIFU Company) was used with an ultrasound device for real-time imaging. Clinical evaluation was performed by imaging (US, CT, MRI) and validated standardized questionnaires (NRS, BPI) before and up to 24 months after HIFU. Results: HIFU treatment was performed in all patients in spite of presence of biliary and/or duodenal stents (4/15) and tumor-induced vascular encasement of abdominal vessels (15/15). The mean treatment time was 111 min, sonication time 1103 s and total energy 386,768J. Postinterventional imaging showed a devaskularisation of treated tumor regions with a significant average volume reduction of 63.8% after 3 months. A significant pain relief was achieved in twelve patients following HIFU therapy (n = 6 completely, n = 6 partially). Conclusion: US-guided HIFU can effectively be used for local tumor control and relief of tumor-associated pain in patients with locally advanced inoperable pancreatic cancer.