title: Ultrasound Guided High Intensity Focused Ultrasound for malignant tumors: The Spanish experience of survival advantage in stage III and IV pancreatic cancer.
abstract: We described the experience of the HIFU Onco Unit of Hospital University Mutua Terrassa (Barcelona, Spain) treating malignant tumors, focusing on results of unresectable pancreatic tumors treated with Ultrasound Guided High Intensity Focused Ultrasound (USgHIFU) hyperthermia ablation in combination with adjuvant chemotherapy.
  
  
  METHODS
  From February 2008 to December 2013, we treated 140 malignant cases. Of those, 48 cases of unresectable pancreatic tumors were treated from March 2010 to December 2013, and the first 43 were included in the analysis. All the 43 cases (29 cases of stage III and 14 cases of stage IV) were treated with systemic chemotherapy. Clinical responses (thermical ablation achieved) were measured by image techniques, and complications were also recorded and analyzed.
  
  
  RESULTS
  The majority of the 140 cases treated at our HIFU center were pancreatic and liver tumors, among which 43 cases of pancreatic tumors were analyzed. Clinical responses (ablation obtained) were observed in 82% of the cases, and the responses lasted at 8 weeks post-procedure. We obtained 11 complete responses (25%) at the end of the combined treatment, nine from stage III patients and two from stage IV patients. Major complications included severe pancreatitis with GI bleeding (1), and skin burning of grade III that required plastic surgery (2). The median survival was 13 months (6 months-2.7 years). No deaths were registered during the course of the treatment.
  
  
  CONCLUSIONS
  HIFU is a potentially effective and safe modality for the treatment of malignant tumors. HIFU proves to have a survival advantage in treating unresectable pancreatic cancer.
authors.affiliation: Surgical Oncology HIFU Unit, Hospital Universitari Mutua Terrassa (HUMT), Pl. Dr. Robert, 5, 08221 Terrassa, Barcelona, Spain. Electronic address: http://www.mutuaterrassa.cat.
authors.forename: Joan
authors.initials: J
authors.lastname: Vidal-Jove
authors.affiliation: Surgical Oncology HIFU Unit, Hospital Universitari Mutua Terrassa (HUMT), Pl. Dr. Robert, 5, 08221 Terrassa, Barcelona, Spain.
authors.forename: Eloi
authors.initials: E
authors.lastname: Perich
authors.affiliation: Medical Direction Departments, Hospital Universitari Mutua Terrassa (HUMT), Pl. Dr. Robert, 5, 08221 Terrassa, Barcelona, Spain.
authors.forename: Manuel Alvarez
authors.initials: MA
authors.lastname: Del Castillo
mesh_terms: D000328:Adult; D000368:Aged; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: Cancer; Chemotherapy; HIFU; High-intensity focused ultrasound ablation; Pancreatic cancer