Usefulness of contrast-enhanced ultrasonography in determining treatment efficacy and outcome after pancreatic cancer chemotherapy.
OBJECTIVE
To investigate if contrast-enhanced ultrasonography (CE-US) is useful for determining treatment efficacy and outcome in the early stages of pancreatic cancer chemotherapy by assessing changes in intratumor hemodynamics using CE-US with a contrast agent.


METHODS
The subjects were 34 patients with unresectable advanced pancreatic cancer treated by chemotherapy. CE-US was assessed after every treatment (course) completion under the same conditions, and patients were divided into two groups according to the intratumor enhancement pattern: Vascular rich (R) group and vascular poor (P) group.


RESULTS
After the second course of treatment, R group in intratumor hemodynamics had 18 patients, and P group had 16 patients. The reduction rates of serum CA19-9 level after chemotherapy which decreased to half or less of the baseline level were 2/15 (0.1%) in P group, but 11/16 (69%) in R group (P = 0.006). When the mean number of courses of chemotherapy and outcome were compared, P group had a mean number of courses of 4.9 (R group, 10.2) and mean survival time (MST) of 246 d (R group, 402 d), showing that outcome was significantly better in R group (P = 0.006).


CONCLUSIONS
CE-US revealed that the change in intratumor blood flow correlated with both serum CA19-9 level and outcome. Patients with serum CA19-9 that decreased to less than half the baseline level, and patients with an abundant intratumor blood flow, had a significantly better outcome. Thus, CE-US is potentially useful for evaluating treatment efficacy and outcome in the early stages of pancreatic cancer chemotherapy.
Sofuni
Atsushi
A
Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. a-sofuni@amy.hi-ho.ne.jp
Itoi
Takao
T
Itokawa
Fumihide
F
Tsuchiya
Takayoshi
T
Kurihara
Toshio
T
Ishii
Kentaro
K
Tsuji
Syujiro
S
Ikeuchi
Nobuhito
N
Moriyasu
Fuminori
F
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D044963:Biopsy, Fine-Needle; D018395:CA-19-9 Antigen / Q000097:blood; D002945:Cisplatin / Q000627:therapeutic use; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D010190:Pancreatic Neoplasms / Q000098:blood supply* / Q000188:drug therapy* / Q000473:pathology; D012039:Regional Blood Flow; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D018395:CA-19-9 Antigen; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine