Early clinical experience using high intensity focused ultrasound for palliation of inoperable pancreatic cancer.

OBJECTIVE To evaluate the safety and efficacy of high intensity focused ultrasound for palliation of inoperable pancreatic cancer in humans. PATIENTS Eighty-nine patients with advanced pancreatic cancer were treated with high intensity focused ultrasound. There were 4 patients with stage II, 39 patients with stage III, and 46 patients with stage IV disease. The location of the tumors was as follows: head of pancreas 34 patients, body and/or tail of pancreas 55 patients. METHODS Pain relief, local tumor control rate, median survival and complications were observed after high intensity focused ultrasound treatment. RESULTS In the clinical treatments in humans the following local tumor control was seen: complete response, 0%; partial response, 14.6%; no change, 57.3%; progressive disease, 28.1%. Pain relief was achieved in 80.6% of patients who had pain prior to high intensity focused ultrasound therapy. The median survival was 26.0 months for patients with stage II disease, 11.2 months for patients with stage III disease, and 5.4 months for patients with stage IV disease. One-year survival rate was as follows: stage II, 100%; stage III, 41.0%; and stage IV, 6.5%. Two-year survival rate was as follows: stage II, 75.0%; stage III, 10.3%; and stage IV, 0%. Complications included superficial skin burns (3.4%), subcutaneous fat sclerosis (6.7%), and an asymptomatic pancreatic pseudocyst (1.1%). There were no severe complications or adverse events related to high intensity focused ultrasound therapy seen in any of the patients treated. CONCLUSIONS Although this retrospective study has significant limitations, preliminary results suggest that the clinical application of high intensity focused ultrasound for pancreatic cancer appears to be safe and is a promising modality of treatment for palliation of pain related to pancreatic cancer.