Changes in tumor vascularity depicted by contrast-enhanced ultrasonography as a predictor of chemotherapeutic effect in patients with unresectable pancreatic cancer.
OBJECTIVE
This study was conducted to assess changes in tumor vascularity using contrast-enhanced ultrasonography in patients with pancreatic carcinoma under systemic chemotherapy and to examine the correlation among vascular change, clinicopathologic factors, and outcome.


METHODS
Forty-one consecutive patients with histopathologically confirmed pancreatic carcinoma who had distant metastases and were under systemic chemotherapy were recruited. Contrast-enhanced ultrasonography was performed before and after 1 and 2 cycles of treatment.The vascular signals from the tumor were continuously recorded,and the highest signal intensity was selected and classified into 5 categories by their intensity.


RESULTS
As for the tumor response determined by dynamic computed tomography after 2 cycles, 6 patients showed a partial response, 25 remained stable, and in 10 patients, the disease progressed. A significant relationship was observed between vascular change after 1 cycle and tumor response (P G 0.001). Progression-free survival and overall survival were significantly short in the case of patients showing increased vascularity after 1 and 2 cycles of chemotherapy, compared with those who did not (P G 0.001).


CONCLUSIONS
Contrast-enhanced ultrasonography was useful to evaluate tumor vascular changes and thereby the effect of systemic chemotherapy, as well as the prognosis of patients with advanced pancreatic carcinoma.
Tawada
Katsunobu
K
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yamaguchi
Taketo
T
Kobayashi
Akitoshi
A
Ishihara
Takeshi
T
Sudo
Kentaro
K
Nakamura
Kazuyoshi
K
Hara
Tarou
T
Denda
Tadamichi
T
Matsuyama
Masato
M
Yokosuka
Osamu
O
D000230:Adenocarcinoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003287:Contrast Media; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000188:drug therapy; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D011134:Polysaccharides; D011237:Predictive Value of Tests; D013997:Time Factors; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
D000970:Antineoplastic Agents; D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508