Microwave ablation of pancreatic head cancer: safety and efficacy.
OBJECTIVE
To evaluate the safety and efficacy of percutaneous microwave (MW) ablation treatment in locally advanced, nonresectable, nonmetastatic pancreatic head cancer.


METHODS
Ten patients with pancreatic head cancer treated with percutaneous (n = 5) or laparotomic (n = 5) MW ablation were retrospectively reviewed. The MW generator used (45 W at 915 MHz) was connected by coaxial cable to 14-gauge straight MW antennas with a 3.7- or 2-cm radiating section. One or two antennae were used, with an ablation time of 10 minutes. Ultrasonographic (US) and combined US/cone-beam computed tomographic (CT) guidance were used in five patients each. Follow-up was performed by CT after 1, 3, 6, and, when possible, 12 months. Tumor response was assessed per Response Evaluation Criteria In Solid Tumors (version 1.1) and Choi criteria. The feasibility, safety, and major and minor complications associated with quality of life (QOL) were recorded prospectively.


RESULTS
The procedure was feasible in all patients (100%). One late major complication was observed in one patient, and no visceral injury was detected. No patient had further surgery, and all minor complications resolved during the hospital stay. An improvement in QOL was observed in all patients despite a tendency to return to preoperative levels in the months following the procedure, without the influence of minor complications. No repeat treatment was performed.


CONCLUSIONS
Despite the small number of patients, the present results can be considered encouraging, showing that MW ablation is a feasible approach in the palliative treatment of pancreatic tumors.
Division of Interventional Radiology, Department of Radiology, University of Insubria, Varese, Italy. Electronic address: gcarraf@gmail.com.
Gianpaolo
G
Carrafiello
Anna Maria
AM
Ierardi
Federico
F
Fontana
Mario
M
Petrillo
Chiara
C
Floridi
Natalie
N
Lucchina
Salvatore
S
Cuffari
Gianlorenzo
G
Dionigi
Antonio
A
Rotondo
Carlo
C
Fugazzola
D000368:Aged; D004564:Electrocoagulation / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use; D010181:Pancreatic Cyst / Q000175:diagnosis / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome
CR; IRE; MW; PD; PR; QOL; RECIST; RF; Response Evaluation Criteria In Solid Tumors; SD; complete response; irreversible electroporation; microwave; partial response; progressive disease; quality of life; radiofrequency; stable disease