Response of patients with locally advanced pancreatic adenocarcinoma to high-intensity focused ultrasound treatment: a single-center, prospective, case series in China
Authors Ji Y, Zhang Y, Zhu JQ, Zhu LL, Zhu YF, Hu K, Zhao H
Received 10 May 2018
Accepted for publication 22 August 2018
Published 9 October 2018 Volume 2018:10 Pages 4439—4446
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Professor Lu-Zhe Sun
Yongshuo Ji,1 Yu Zhang,1 Junqiu Zhu,1 Linglin Zhu,1 Yanfei Zhu,1 Kaimeng Hu,2 Hong Zhao1
1HIFU Center of Oncology Department, Huadong Hospital Affiliated to Fudan University, Shanghai 200000, China; 2Marketing Department, Shanghai A&S Science Technology Development Co., Ltd, Shanghai 200000, China
Purpose: Patients with unresectable locally advanced pancreatic cancer (LAPC) are still in dire need of effective therapies. We performed this cohort study in order to assess the efficacy and safety of high-intensity focused ultrasound (HIFU) ablation in treating patients with unresectable LAPC.
Patients and methods: Eighty-seven cases with unresectable LAPC from January 2014 to December 2016 were finally recruited according to the inclusion criteria. The primary end point of our study was OS of all the cases, and the secondary end points included 6-month and 12-month survival rate, tumor response rate, carbohydrate antigen (CA) 19-9 response rate, VAS, quality of life, and safety.
Results: All the 87 patients received HIFU ablation successfully, and were included in the efficacy and safety analysis. With a median follow-up of 16 months, median OS was estimated to be 12.2 months, with 95 % CI of 11.1–12.7 months. The 6-month and 12-month survival rates were 94.25% (95% CI =86.74–97.57) and 50.85% (95% CI =38.17–62.21), respectively. Multivariate analysis revealed that patients with VAS <4, Karnofsky performance status ≥80, and tumor size <3 cm have a significant improvement in their OS (adjusted HR [aHR] =0.26 [95% CI =0.12–0.57], P=0.001; aHR =0.34 [95% CI =0.17–0.68], P=0.02; and aHR =0.39 [95% CI =0.20–0.78], P=0.007; respectively). Tumor responses were observed in 32 (36.8%) of 87 patients and CA 19-9 response rate was 56.2%. Global health status, physical function, emotional function, and cognitive function of patients were significantly improved after HIFU treatment, and symptoms of fatigue and pain were significantly reduced. A total of 28.7% (25/87) of patients reported adverse events (AEs), mainly including fatigue (14/87), abdominal pain (7/87), fever (7/87), nausea (5/87), and rash (4/87). No severe AEs and HIFU-related deaths were reported.
Conclusion: HIFU ablation might be a potentially effective and safe therapeutic option for the patients with unresectable LAPC.
Keywords: HIFU, locally advanced pancreatic cancer, unresectable, survival, response, quality of life
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