ObjectiveTo explore the application value of high intensity focused ultrasound (HIFU) in the treatment of advanced pancreatic cancer.MethodThe domestic and foreign literatures about studies of HIFU treating advanced pancreatic cancer in recent years were retrieved and summarized.ResultsHIFU could prolong the survival time, control pain, and enhance the body’s immune function in patients with advanced pancreatic cancer. There were no obvious serious complications during the treatment process. The combined treatment with radiotherapy, chemotherapy, and traditional Chinese medicine could obviously prolong the survival time and improve the quality of life for the patients with advanced pancreatic cancer.ConclusionsHIFU is an important component in the comprehensive treatment of advanced pancreatic cancer. However, because there is no uniform standard for the dosage of HIFU treatment, the sample size of many related studies is small, so the research results have certain limitations, so more studies are needed to improve their understanding of advanced pancreatic cancer in order to better serve clinical workin future.
ObjectiveTo evaluate the clinical efficacy, safety, and survival outcomes of CT-guided iodine-125 seed implantation in patients with stage Ⅲ–Ⅳ pancreatic cancer, and to analyze the relevant factors influencing prognosis. MethodsClinical data of patients with stage Ⅲ–Ⅳ pancreatic cancer who underwent CT-guided iodine-125 seed implantation and had complete follow-up records at the First Affiliated Hospital of Army Medical University from June 2013 to February 2023 were retrospectively collected. Post-treatment efficacy, the Karnofsky performance status (KPS) score and numeric rating scale (NRS) score for pain at one month post-procedure, and postoperative complications were analyzed. The overall survival (OS) was also analyzed. Univariate and multivariate Cox proportional hazards regression models were employed to identify risk factors influencing OS. ResultsA total of 44 eligible patients with stage Ⅲ–Ⅳ pancreatic cancer were included in this study. According to the response evaluation criteria in solid tumors 1.1 criteria, the objective response rate was 61.4% (27/44) and the disease control rate was 95.5% (42/44). At one month postoperatively, the KPS score significantly improved from a preoperative value of (78.18±5.40) points to (86.82±5.18) points (P<0.001); the pain NRS score significantly decreased from a preoperative median [interquartile range (IQR)] of 4 (3, 5) to 1 (0, 2.5), P<0.001. The preoperative planned target volume D90 was 120 (116, 125) Gy, and the postoperative delivered D90 was 124 (119, 127) Gy (P=0.060). The median overall survival (OS) was 17.0 months for stage Ⅲ patients and 12.0 months for stage Ⅳ patients (P=0.05). Multivariate analysis revealed that clinical stage [Stage Ⅳ vs. Ⅲ: HR (95%CI)=2.29 (1.16, 4.50), P=0.016] and gross tumor volume [HR (95%CI)=1.01 (1.00, 1.02), P=0.012] were independent prognostic factors affecting OS. ConclusionsBased on the retrospective analysis results of this study, CT-guided iodine-125 seed implantation, as a local treatment modality for stage Ⅲ–Ⅳ pancreatic cancer, can effectively achieve local tumor control, alleviate pain, improve quality of life, and prolong survival of patients, with particularly significant benefits observed in stage Ⅲ patients, and demonstrates a favorable safety profile. Clinical stage Ⅳ and increased gross tumor volume are identified as independent factors affecting OS. This technique provides a treatment option for patients with inoperable stage Ⅲ–Ⅳ pancreatic cancer.
