title: Percutaneous ultrasonography and computed tomography guided pancreatic cryoablation: feasibility and safety assessment.
abstract: OBJECTIVE
  To assess the safety and feasibility of percutaneous cryoablation on pancreatic cancer via ultrasonography (US) and computed tomography (CT) guidance.
  
  
  METHODS
  This retrospective review was approved by the institutional review board and of informed consent. Thirty-two patients (18 men and 14 women; median age 62; age range, 30-77 years) with pancreatic cancer (stage II/III/IV, 3/11/18) treated with percutaneous US and CT guided cryoablations between February 2009 and February 2010 were eligible for this review. Thirteen tumors in pancreatic head and 19 in pancreatic body and/or tail measuring 2-11 cm (mean, 5.2 cm±8 [standard deviation]) were ablated with 49 procedures in total. Feasibility was analyzed by enhanced CT 1-3 months post procedure and safety was assessed by clinical signs, symptoms and laboratory results.
  
  
  RESULTS
  Neither procedural death nor serious complications occurred. Fifteen tumors (46.9%) smaller than 5 cm were successfully ablated by one session of cryoablation. Twenty-seven patients experienced a ≥50% reduction in pain score, 22 experienced a 50% decrease in analgesic consumption and 16 experienced a ≥20 increase in Karnofsky Performance Status (KPS) Score. Partial response (PR) and stable disease (SD) turned up in 9 and 21 patients, respectively, lesions in whom were identified controlled by none enhancement on enhanced CT. Mean and median survival was 15.9 and 12.6 months, respectively. The 6-, 12- and 24-month survival rates were 82.8%, 54.7% and 27.3%, respectively.
  
  
  CONCLUSIONS
  US and CT guided percutaneous cryoablation is a safe and promising local treatment for pancreatic cancer.
authors.affiliation: Department of Oncology, Fuda Cancer Hospital, Guangzhou, China.
authors.forename: Lizhi
authors.initials: L
authors.lastname: Niu
authors.forename: Lihua
authors.initials: L
authors.lastname: He
authors.forename: Liang
authors.initials: L
authors.lastname: Zhou
authors.forename: Feng
authors.initials: F
authors.lastname: Mu
authors.forename: Binghui
authors.initials: B
authors.lastname: Wu
authors.forename: Haibo
authors.initials: H
authors.lastname: Li
authors.forename: Zhenzhong
authors.initials: Z
authors.lastname: Yang
authors.forename: Jiansheng
authors.initials: J
authors.lastname: Zuo
authors.forename: Kecheng
authors.initials: K
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography