Clinical Use of High-Intensity Focused Ultrasound (HIFU) for Tumor and Pain Reduction in Advanced Pancreatic Cancer Klinischer Einsatz des hoch-intensiven fokussierten Ultraschalls (HIFU) zur Tumor- und Schmerzreduktion bei fortgeschrittenem Pankreas- karzinom

Correspondence Milka Marinova, PhD, MD Department of Radiology, Hospital & Medical School, University of Bonn Siegmund-Freud-Str. 25 D-53105 Bonn Germany Tel.: ++ 49/2 28/287110 17 Fax: ++ 49/2 28/2 87/9 011017 [email protected]. de Abstract ▼ Purpose: Evaluation of ultrasound-guided high-intensity focused ultrasound (HIFU) used for the first time in Germany in patients with inoperable pancreatic cancer for reduction of tumor volume and relief of tumor-associated pain. Materials andMethods: 15 patients with locally advanced inoperable pancreatic cancer and tumor-related pain symptoms were treated by HIFU (n=6 UICC stage III, n = 9 UICC stage IV). 13 patients underwent simultaneous standard chemotherapy. Ablation was performed using the JC HIFU system (Chongqing, China HAIFU Company) with an ultrasonic device for real-time imaging. Imaging follow-up (US, CT, MRI) and clinical assessment using validated questionnaires (NRS, BPI) was performed before and up to 15months after HIFU. Results: Despite biliary or duodenal stents (4/ 15) and encasement of visceral vessels (15/ 15), HIFU treatment was performed successfully in all patients. Treatment time and sonication time were 111min and 1103 s, respectively. The applied total energy was 386768 J. After HIFU ablation, contrast-enhanced imaging showed devascularization of treated tumor regions with a significant average volume reduction of 63.8% after 3 months. Considerable pain relief was achieved in 12 patients after HIFU (complete or partial pain reduction in 6 patients). Conclusion: US-guided HIFU with a suitable acoustic pathway can be used for local tumor control and relief of tumor-associated pain in patients with locally advanced pancreatic cancer. Key points: ▶ US-guided HIFU allows an additive treatment of unresectable pancreatic cancer. ▶ HIFU can be used for tumor volume reduction. ▶ Using HIFU, a significant reduction of cancer-related pain was achieved. ▶ HIFU provides clinical benefit in patients with pancreatic cancer. Citation Format: ▶ Strunk HM, Henseler J, Rauch M et al. Clinical Use of High-Intensity Focused Ultrasound (HIFU) for Tumor and Pain Reduction in Advanced Pancreatic Cancer. Fortschr Röntgenstr 2016; 188: 662–670