Ultrasound-Based Therapies not Mentioned
The article discusses various chemotherapy regimens in the section on palliative treatment of pancreatic carcinoma (1), but regretfully fails to mention the treatment with ultrasound-guided high-intensity focused ultrasound (HIFU). HIFU is an innovative method, enabling targeted, non-invasive thermal ablation. In recent years, many reports about the use of high-intensity focused ultrasound with various diseases have been published, with a focus on the treatment of benign and malignant solid tumors. Current experience indicates that the proximity of a tumor to blood vessels does not play an important role, probably because the heat is rapidly removed by the blood stream. Thus, in principle, HIFU can be used to treat any solid space-occupying lesion accessible to ultrasound guidance, including, for example, uterine fibroids, skeletal and liver tumors, as well as pancreatic tumors encasing blood vessels. This is confirmed by the experiences we have gained in our hospital (the only ultrasound-guided HIFU system available in the German-speaking countries is located in Bonn, Germany) and by studies most of which have been performed in the East Asian region. These studies provide insight in the use of HIFU for pain relief and local tumor control: Gao et al. report (2) about the HIFU treatment of 39 patients with locally advanced pancreatic cancer. Pain relief was achieved in 79.5% of these patients. Another study of 251 patients (3) with advanced pancreatic cancer showed that HIFU treatment did not only reduce tumor size without serious complications, but also improved overall survival. A phase II study (4) evaluated HIFU treatment in combination with gemcitabin in patients with locally advanced pancreatic cancer. Two patients had a complete response and 15 patients a partial response.
Dr. med. Dr. rer. nat. Milka Marinova, Dr. med. Maximilian Rauch, Prof. Dr. med. Holger Strunk
Radiologische Universitätsklinik Bonn, firstname.lastname@example.org
Conflict of interest statement
The authors declare that no conflict of interest exists.
|1.||Seufferlein T, Porzner M, Heinemann V, et al.: Clinical practice guideline: Ductal pancreatic adenocarcinoma—surgery, pathology work-up, and neoadjuvant, adjuvant and palliative treatments. Dtsch Arztebl Int 2014; 111: 396–402. VOLLTEXT|
|2.||Gao HF, Wang K, Meng ZQ, et al.: High intensity focused ultrasound treatment for patients with local advanced pancreatic cancer. Hepatogastroenterology 2013; 60: 1906–10. MEDLINE|
|3.||Sofuni A, Moriyasu F, Sano T, et al.: The current potential of high-intensity focused ultrasound for pancreatic carcinoma. J Hepatobiliary Pancreat Sci 2011; 18: 295–303. CrossRef MEDLINE|
|4.||Zhao H, Yang G, Wang D, et al.: Concurrent gemcitabine and high-intensity focused ultrasound therapy in patients with locally advanced pancreatic cancer. Anticancer Drugs 2010; 21: 447–52. |