title: High-intensity focused ultrasound (HIFU) for pancreatic carcinoma: evaluation of feasibility, reduction of tumour volume and pain intensity.
abstract: OBJECTIVE
  Prognosis of patients with locally advanced pancreatic adenocarcinoma is extremely poor. They often suffer from cancer-related pain reducing their quality of life. This prospective observational study aimed to evaluate feasibility, local tumour response, and changes in quality of life and symptoms in Caucasian patients with locally advanced pancreatic cancer treated by ultrasound-guided high-intensity focused ultrasound (HIFU).
  
  
  METHODS
  Thirteen patients underwent HIFU, five with stage III, eight with stage IV UICC disease. Ten patients received simultaneous palliative chemotherapy. Postinterventional clinical assessment included evaluation of quality of life and symptom changes using standardized questionnaires. CT and MRI follow-up evaluated the local tumour response.
  
  
  RESULTS
  HIFU was successfully performed in all patients. Average tumour reduction was 34.2 % at 6 weeks and 63.9 % at 3 months. Complete or partial relief of cancer-related pain was achieved in 10 patients (77 %), five of whom required less analgesics for pain control. Quality of life was improved revealing increased global health status and alleviated symptoms. HIFU treatment was well tolerated. Eight patients experienced transient abdominal pain directly after HIFU.
  
  
  CONCLUSIONS
  HIFU ablation of pancreatic carcinoma is a feasible, safe and effective treatment with a crucial benefit in terms of reduction of tumour volume and pain intensity.
  
  
  CONCLUSIONS
  • US-guided HIFU is feasible and safe for patients with unresectable pancreatic cancer. • HIFU can considerably reduce tumour volume and cancer-related pain. • Patients treated with HIFU experienced significant and lasting reduction of pain intensity. • HIFU has a crucial clinical benefit for patients with pancreatic cancer.
authors.affiliation: Department of Radiology, Medical School & Hospital, University of Bonn, Siegmund-Freud-Str. 25, D-53105, Bonn, Germany. milka.marinova@ukb.uni-bonn.de.
authors.forename: Milka
authors.initials: M
authors.lastname: Marinova
authors.affiliation: Department of Radiology, Medical School & Hospital, University of Bonn, Siegmund-Freud-Str. 25, D-53105, Bonn, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Rauch
authors.affiliation: Department of Palliative Medicine, Medical School & Hospital, University of Bonn, Bonn, Germany.|Department of General Practice and Family Medicine, Medical School & Hospital, University of Bonn, Bonn, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Mücke
authors.affiliation: Department of Palliative Medicine, Medical Faculty RWTH Aachen University, Aachen, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Rolke
authors.affiliation: Department of Internal Medicine I, Medical School & Hospital, University of Bonn, Bonn, Germany.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Gonzalez-Carmona
authors.affiliation: Department of Radiology, Medical School & Hospital, University of Bonn, Siegmund-Freud-Str. 25, D-53105, Bonn, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Henseler
authors.affiliation: Department of Palliative Medicine, Medical School & Hospital, University of Bonn, Bonn, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Cuhls
authors.affiliation: Department of Palliative Medicine, Medical School & Hospital, University of Bonn, Bonn, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Radbruch
authors.affiliation: Department of Internal Medicine I, Medical School & Hospital, University of Bonn, Bonn, Germany.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Strassburg
authors.affiliation: Clinical Center of Tumor Therapy Chongqing, Chongqing, China.
authors.forename: Lian
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Medical School & Hospital, University of Bonn, Siegmund-Freud-Str. 25, D-53105, Bonn, Germany.
authors.forename: Hans H
authors.initials: HH
authors.lastname: Schild
authors.affiliation: Department of Radiology, Medical School & Hospital, University of Bonn, Siegmund-Freud-Str. 25, D-53105, Bonn, Germany.
authors.forename: Holger M
authors.initials: HM
authors.lastname: Strunk
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D047368:Tumor Burden; D018084:Ultrasonography, Interventional
keywords: High-intensity focused ultrasound; Intervention; Pain relief; Pancreatic cancer; Tumour ablation