head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2019, vol. 25, issue1
Subject Area: Medicine
DOI: 10.5272/jimab.2019251.2384
Published online: 22 February 2019

Original article

J of IMAB. 2019 Jan-Mar;25(1):2384-2389
Dobromir Dimitrov1ORCID logo, Martin Karamanliev1ORCID logo Corresponding Autoremail, Nadya Stanislavova2ORCID logo, Hyulia Feradova3ORCID logo, Yoana Ivanova-Yoncheva4ORCID logo, Tsanko Yotsov6ORCID logo, Vasil Neykov6ORCID logo, Kun Zhou5ORCID logo, Grigor Gorchev4ORCID logo, Tsvetomir Ivanov1ORCID logo, SlavchoTomov4ORCID logo,
1) Department of Surgical Oncology, University Hospital Dr Georgi Stranski Medical University - Pleven, Bulgaria.
2) Department of Radiology, UMHAT St. Marina, Medical University – Pleven, Bulgaria.
3) Department of General Surgery, UMHAT St. Marina, Medical University – Pleven, Bulgaria.
4) Department of Gynaecology, UMHAT St. Marina, Medical University – Pleven, Bulgaria.
5) Clinical Center for Tumor Therapy, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
6) Medical student, Medical University – Pleven, Bulgaria.

Purpose: Our purpose is to study the clinical safety of focused ultrasound surgery (FUS) in the treatment of patients with advanced pancreatic cancer. Methods: A single-center prospective study was conducted in the period 02. 2013 - 06. 2018 at HIFU department at University hospital St. Marina – Pleven, Bulgaria looking at the postoperative complications after focused ultrasound surgery of advanced pancreatic cancer patients. Results: 47 patients were included in the study with a III or IV stage pancreatic cancer. The complication rate was 10.6% and no severe complications were observed. Conclusions: FUS seems to be a safe method of treating patients with advanced pancreatic cancer. Large randomized trials in the area are needed.

Keywords: pancreatic cancer, postoperative complications, High-intensity focused ultrasound,

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Please cite this article as: Dimitrov D, Karamanliev M, Stanislavova N, Feradova H, Ivanova-Yoncheva Y, Yotsov Ts, Neykov V, Zhou K, Gorchev G, Ivanov Ts, Tomov S. Clinical safety of focused ultrasound surgery in the treatment of advanced pancreatic cancer patients - single center prospective study. J of IMAB. 2019 Jan-Mar;25(1):2384-2389. DOI: 10.5272/jimab.2019251.2384

Corresponding AutorCorrespondence to: Martin Karamanliev, M.D. Surgical oncology department, Georgi Stranski Hospital, Medical University - Pleven; 8A Georgi Kochev blvd, Pleven, 5800, Bulgaria; E-mail: martinkaramanliev1@gmail.com

1. DeVita VT, Hellman S, Rosenberg SA. Cancer: principles and practice of oncology. Philadelphia, Pa: Lippincott Williams & Wilkins, 2001
2. Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin. 2002 Jan-Feb;52(1):23-47. [PubMed] [Crossref]
3. Huguet F, Girard N, Guerche CS, Hennequin C, Mornex F, Azria D. Chemoradiotherapy in themanagement of locally advanced pancreatic carcinoma: a qualitativesystematic review. J Clin Oncol. 2009 May;27(13):2269-77. [PubMed] [Crossref]
4. Chauffert B, Mornex F, Bonnetain F, Rougier P, Mariette C, Bouché O, et al. Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine withgemcitabine alone for locally advanced unresectable pancreatic cancer. Definitive results of the 2000-01 FFCD/SFRO study. Ann Oncol. 2008 Sep;19(9):1592-9. [PubMed] [Crossref]
5. Sultana A, Tudur SC, Cunningham D, Starling N, Tait D, Neoptolemos JP, et al. Systematic review, including meta-analyses, on the management of locally advanced pancreatic cancer using radiation/combined modality therapy. Br J Cancer. 2007 Apr;96(8):1183-90. [PubMed] [Crossref]
6. Dubinsky TJ, Cuevas C, Dighe MK, Kolokythas O, Hwang JH. High-intensity focusedultrasound: current potential and oncologic applications. AJR Am J Roentgenol. 2008 Jan;190(1):191-9. [PubMed] [Crossref]
7. Wu F, Chen WZ, Bai J, Zou JZ, Wang ZL, Zhu H, et al. Pathological changes in human malignant carcinoma treated with high-intensity focused ultrasound. Ultrasound Med Biol. 2001 Aug;27(8):1099-106. [PubMed] [Crossref]
8. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. [PubMed] [Crossref]
9. Hill CR, Rivens IH, Vaughan MG, ter Haar G. Lesion development in focused ultrasound surgery: a general model. Ultrasound Med Biol. 1994; 20(3):259-69. [PubMed]
10. Lynn JG, Zwemer RL, Chick AJ, Miller AG. A new method for the generation and use of focused ultrasound in experimental biology. J Gen Physiol. 1942 Nov 20;26(2):179-93. [PubMed] [Crossref]
11. Strunk H, Henseler J, Rauch M, Mьcke M, Kukuk G, Cuhls H, et al. Clinical Use of High-Intensity Focused Ultrasound (HIFU) for Tumor and Pain Reduction in Advanced Pancreatic Cancer. Rofo. 2016 Jul;188(7):662-70. [PubMed] [Crossref]
12. Wang K, Chen Z, Meng Z, Lin J, Zhou Z, Wang P et al. Analgesic effect of high intensity focused ultrasound therapy for unresectable pancreatic cancer. Int J Hyperthermia. 2011 Mar;27(2):101-7. [PubMed] [Crossref]
13. Orgera G, Monfardini L, Della Vigna P, Zhang L, Bonomo G, Arnone P, et al. High-intensity focused ultrasound (HIFU) in patients with solid malignancies: evaluation of feasibility, local tumour response and clinical results. Radiol Med. 2011 Aug;116(5):734-48. [PubMed] [Crossref]
14. Vidal-Jove, Joan, EloiPerich, Manuel Alvarez del Castillo. Ultrasound guided high intensity focused ultrasound for malignant tumors: the Spanish experience of survival advantage in stage III and IV pancreatic cancer. Ultrason Sonochem. 2015 Nov;27:703-6. [PubMed] [Crossref
15. Marinova M, Huxold HC, Henseler J, Mücke M, Conrad R, Rolke R, et al. Clinical Effectiveness and Potential Survival Benefit of US-Guided High-Intensity Focused Ultrasound Therapy in Patients with Advanced-Stage Pancreatic Cancer. Ultraschall Med. 2018 Apr 17. [Epub ahead of print] [PubMed] [Crossref]
16. Orsi F, Zhang L, Arnone P, Orgera G, Bonomo G, Vigna PD еt al. High-Intensity Focused Ultrasound Ablation: Effective and Safe Therapy for Solid Tumors in Difficult Locations. AJR Am J Roentgenol. 2010 Sep;195(3):245-52. [PubMed]
17. Wu F, Wang ZB, Zhu H, Chen WZ, Zou JZ, Bai J, et al. Feasibility of US-guided high-intensity focused ultrasound treatment in patients with advanced pancreatic cancer: Initial experience. Radiology. 2005; 236: 1034-40. [PubMed]
18. Gu Y, Wang G, Xia H, Xu Y, Pan Y, Zhang H et al. Application of high intensity focused ultrasound in treating 45 cases of carcinoma of the pancreas. [in Chinese] FudanUniv J Med Sci. 2005; 31:135–141 [Google scholar]
19. Wang R, Mu Q, Liu L, Shu Y. A clinical study of thermotherapy of HIFU in combination with chemotherapy on treating advanced pancreatic cancer. [in Chinese]. Acta Nanjing Med Univ. 2003; 23:460–463 [Google scholar]
20. Wang X, Sun JZ. Preliminary study of high intensity focused ultrasound in treating patients with advanced pancreatic carcinoma.  [in Chinese]. Chin J Gen Surg 2002; 17:654–655 [Google scholar]
21. Wu F, Wang ZB, Zhu H, Chen W, Zou J, Bai J, et al. Feasibility of USguided high-intensity focused ultrasound treatment in patients with advanced pancreatic cancer: initial experience. Radiology. 2005 Sep;236(3):1034-40. [PubMed] [Crossref]
22. Xie DR, Chen D, Teng H. A multicenter nonrandomized clinical study of high intensity focused ultrasound in treating patients with local advanced pancreatic carcinoma. [in Chinese] Chin J Clin Oncol. 2003; 30:630–634 [Google scholar]
23. Xiong L, He C, Yao S. The preliminary clinical results of the treatment for advanced pancreatic carcinoma by high intensity focused ultrasound [in Chinese]. Chin J Gen Surg 2005; 16:345–347 [Google scholar]
24. Xu YQ, Wang GM, Gu YZ, Zhang HF. The acesodyne effect of high intensity focused ultrasound on the treatment of advanced pancreatic carcinoma [in Chinese]. Clin Med J China 2003; 10:322–323 [Google scholar]
25. Yuan C, Yang L, Yao C. Observation of high intensity focused ultrasound treating 40 cases of pancreatic cancer. [in Chinese] Chin J ClinHepatol 2003; 19:145–146 [Google scholar]
26. Wu F, Wang ZB, Chen WZ, Wang W, Gui Y, Zhang M et al. Extracorporeal high intensity focused ultrasound ablation in the treatment of 1038 patients with solid carcinomas in China: an overview. UltrasonSonochem. 2004 May;11(3-4):149-54. [PubMed]
27. Sung HY, Jung SE, Cho SH, Zhou K, Han JY, Han ST et al. Long-term outcome of high-intensity focused ultrasound in advanced pancreatic cancer. Pancreas. 2011 Oct;40(7):1080-6. [PubMed]
28. Strunk HM, Lutzow C, Henseler J, Mucke M, Rauch M, Marx C, et al. Mesenteric Vessel Patency Following HIFU Therapy in Patients with Locally Invasive Pancreatic Cancer. Ultraschall Med. 2018 Dec;39(6):650-658. [PubMed] [Crossref]
29. He SX, Wang GM. The noninvasive treatment of 251 cases of advanced pancreatic cancer with focused ultrasound surgery. In: Andrew MA, Crum LA, Vaezy S, editors. Seattle: University of Washington; Proceedings from the 2nd International Symposium on Therapeutic Ultrasound. 2002:51-6.
30. Fegrachi S, Besselink MG , van Santvoort HC, van Hillegersberg R, Molenaar IQ. Radiofrequency ablation for unresectable locally advanced pancreatic cancer: a systematic review. HPB (Oxford). 2014 Feb;16(2):119-23. [PubMed]
31. Pezzilli R, Raffaele. The problems of radiofrequency ablation as an approach for advanced unresectable ductal pancreatic carcinoma. Cancers. 2010;2:1419-31. [PubMed]
32. Pandya GJ. Radiofrequency ablation of pancreatic ductal adenocarcinoma: the past, the present and future. World J Gastrointest Oncol. 2015;7:6-11. [PubMed]
33. Wu Y, Tang Z, Fang H, Gao S, Chen J, Wang Y, et al. High operative risk of cool tip radiofrequency ablation for unresectable pancreatic head cancer. J Surg Oncol. 2006 Oct 1;94(5):392-5. [PubMed] [Crossref]
34. Matsui Y, Nakagawa A, Kamiyama Y, Yamamoto K, Kubo N, Nakase Y. Selective thermocoagulation of unresectable pancreatic cancers by using radiofrequency capacitive heating. Pancreas. 2000 Jan;20(1):14-20. [PubMed]
35. Martin RC, McFarland K, Ellis S, Velanovich V. Irreversible electroporation therapy in the management of locally advanced pancreatic adenocarcinoma. J Am Coll Surg. 2012 Sep;215(3):361-9. [PubMed] [Crossref]
36. Carrafiello G, Ierardi AM, Fontana F, Petrillo M, Floridi C, Lucchina N, et al. Microwave ablation of pancreatic head cancer: safety and efficacy. J Vasc Interv Radiol. 2013;24:1513-20. [PubMed] [Crossref]
37. Arcidiacono PG, Carrara S, Reni M, Petrone MC, Cappio S, Balzano G, et al. Feasibility and safety of EUS-guided cryothermal ablation in patients with locally advanced pancreatic cancer. Gastrointest Endosc. 2012 Dec;76(6):1142-51. [PubMed]
38. Kovach SJ, Hendrickson RJ, Cappadona CR, Schmidt CM, Groen K, Koniaris LG, et al. Cryoablation of unresectable pancreatic cancer. Surgery. 2002 Apr;131(4):463-4. [PubMed] [Crossref]
39. Niu L, Wang Y, Yao F, Wei C, Chen Y, Zhang L, et al. Alleviating visceral cancer pain in patients with pancreatic cancer using cryoablation and celiac plexus block. Cryobiology. 2013 Apr;66(2):105-11. [PubMed] [Crossref].

Received: 14 October 2018
Published online: 22 February 2019

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