title: Is alcohol required for effective pancreatic cyst ablation? The prospective randomized CHARM trial pilot study.
abstract: OBJECTIVE
  In this study, we aim to determine the safety and feasibility of an alcohol-free approach to pancreatic cyst ablation using a chemotherapeutic ablation cocktail.
  
  
  METHODS
  In this prospective, randomized, double-blinded pilot study, 10 patients with known mucinous type pancreatic cysts underwent endoscopic ultrasound (EUS)-guided fine needle aspiration and then lavage with either 80 % ethanol or normal saline. Both groups were then treated with a cocktail of paclitaxel and gemcitabine. Primary outcomes were reduction in cyst volume and rates of complications.
  
  
  RESULTS
  At 6 months, patients randomized to the alcohol arm had an 89 % average volume reduction, with a 91 % reduction noted in the alcohol-free arm. Complete ablation was achieved in 67 % of patients in the alcohol-free arm at both 6 and 12 months, whereas the alcohol group recorded complete ablation rates of 50 % and 75 % at 6 and 12 months, respectively. One patient in the alcohol arm developed acute pancreatitis (20 %) with no adverse events in the alcohol-free arm.
  
  
  CONCLUSIONS
  This study revealed similar ablation rates between the alcohol ablation group and the alcohol-free arm and demonstrates the safety and feasibility of an alcohol-free ablation protocol. This pilot study suggests that alcohol may not be required for effective cyst ablation.
authors.affiliation: Penn State Hershey Medical Center - Gastroenterology and Hepatology, Hershey, Pennsylvania, United States.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Moyer
authors.affiliation: Penn State Hershey Medical Center - Gastroenterology and Hepatology, Hershey, Pennsylvania, United States.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Dye
authors.affiliation: Penn State Hershey Medical Center - Gastroenterology and Hepatology, Hershey, Pennsylvania, United States.
authors.forename: Setareh
authors.initials: S
authors.lastname: Sharzehi
authors.affiliation: Penn State Hershey Medical Center - Gastroenterology and Hepatology, Hershey, Pennsylvania, United States.
authors.forename: Brooke
authors.initials: B
authors.lastname: Ancrile
authors.affiliation: Penn State Hershey Medical Center - Gastroenterology and Hepatology, Hershey, Pennsylvania, United States.
authors.forename: Abraham
authors.initials: A
authors.lastname: Mathew
authors.affiliation: Penn State Hershey Medical Center - Gastroenterology and Hepatology, Hershey, Pennsylvania, United States.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: McGarrity
authors.affiliation: Penn State Hershey Medical Center - Surgical Oncology, Hershey, Pennsylvania, United States.
authors.forename: Niraj
authors.initials: N
authors.lastname: Gusani
authors.affiliation: Penn State Hershey Medical Center - Hematology and Oncology, Hershey, Pennsylvania, United States.
authors.forename: Nelson
authors.initials: N
authors.lastname: Yee
authors.affiliation: Penn State Hershey Medical Center - Surgical Oncology, Hershey, Pennsylvania, United States.
authors.forename: Joyce
authors.initials: J
authors.lastname: Wong
authors.affiliation: Penn State Hershey Medical Center - Gastroenterology and Hepatology, Hershey, Pennsylvania, United States.
authors.forename: John
authors.initials: J
authors.lastname: Levenick
authors.affiliation: Penn State Hershey Medical Center - Gastroenterology and Hepatology, Hershey, Pennsylvania, United States.
authors.forename: Brandy
authors.initials: B
authors.lastname: Dougherty-Hamod
authors.affiliation: Penn State Hershey Medical Center - General Internal Medicine, Hershey, Pennsylvania, United States.
authors.forename: Bradley
authors.initials: B
authors.lastname: Mathers