Real-world response of patients with locally advanced pancreatic adenocarcinoma to high intensity focused ultrasound treatment: a single-center, observational study in China

Congye Wu, Xinmei Wu, Huanyu Zhao, Dongying Gu, Xiaowei Wei, Cuiju Tang, Jinfei Chen


Background: The purpose of this study was to evaluate the feasibility of high intensity focused ultrasound (HIFU) ablation for tumor response and local control in selected patients with unresectable locally advanced pancreatic cancer (LAPC).
Methods: Forty-six malignant cases of unresectable pancreatic cancer were treated in our center from February 2013 to December 2016, and were included in this analysis. Response was determined with the response evaluation criteria in solid tumors (RECIST v1.1). Overall survival (OS), including 12-month survival rates and complications were also recorded and analyzed.
Results: Clinical responses (ablation obtained) were observed in 43.48% of the cases, and disease control [complete response (CR), partial response (PR), and stable disease (SD)] was observed in 43 (93.48%) of 46 cases. Stratified analyses suggested that receiving radiotherapy per-HIFU might affect the response rate. Median OS was 9.7 months, with 95% CI, 7.9–13.2 months. The 1-year survival rate was estimated to be 46.69% (95% CI, 31.71–60.34%). Age <65 years, tumors located in the tail of pancreas, stage III, receiving targeted therapy per-HIFU, time to HIFU from diagnose <2 months, and receiving HIFU therapy for more than 10 times was detected to be significant associated with the improvement of median survival time (MST) and 1-year survival rate by univariate analysis. However, multivariate analysis did not support the association. Major complications included fatigue [2], abdominal pain [2], fever [1], GI bleeding [1]. No deaths were registered during the course of the treatment.
Conclusions: HIFU is a potentially effective and safe modality for the treatment of malignant tumors. HIFU proves to have a survival advantage in treating unresectable pancreatic cancer.