title: [High-intensity focused ultrasound (HIFU) for tumor pain relief in inoperable pancreatic cancer : Evaluation with the pain sensation scale (SES)].
abstract: BACKGROUND
  High-intensity focused ultrasound (HIFU) in combination with palliative standard therapy is an innovative and effective treatment option for pain reduction in patients with inoperable pancreatic cancer.
  
  
  OBJECTIVE
  Evaluation of the effects of additive ultrasound (US)-guided HIFU treatment in inoperable pancreatic cancer on the sensory and affective pain perception using validated questionnaries.
  
  
  METHODS
  In this study 20 patients with locally advanced inoperable pancreatic cancer and tumor-related pain were treated by US-guided HIFU (6 stage III, 12 stage IV according to UICC and 2 with local recurrence after surgery). Ablation was performed using the JC HIFU system (HAIFU, Chongqing, China) with an ultrasonic device for real-time imaging. Clinical assessment included evaluation of pain severity using validated questionnaires with particular attention to the pain sensation scale (SES) with its affective and sensory component and the numeric rating scale (NRS).
  
  
  RESULTS
  The average pain reduction after HIFU was 2.87 points on the NRS scale and 57.3 % compared to the mean baseline score (n = 15, 75 %) in 19 of 20 treated patients. Four patients did not report pain relief, however, the previous opioid medication could be stopped (n = 2) or the analgesic dosage could be reduced (n = 2). No pain reduction was achieved in one patient. Furthermore, after HIFU emotional as well as sensory pain aspects were significantly reduced (before vs. 1 week after HIFU, p < 0.05 for all pain scales).
  
  
  CONCLUSIONS
  US-guided HIFU can be used for effective and early pain relief and reduction of emotional and sensory pain sensation in patients with locally advanced pancreatic cancer.
authors.affiliation: Radiologische Klinik, Universitätsklinikum, Siegmund-Freud-Str. 25, 53105, Bonn, Deutschland. milka.marinova@ukb.uni-bonn.de.
authors.forename: M
authors.initials: M
authors.lastname: Marinova
authors.affiliation: Radiologische Klinik, Universitätsklinikum, Siegmund-Freud-Str. 25, 53105, Bonn, Deutschland.
authors.forename: H M
authors.initials: HM
authors.lastname: Strunk
authors.affiliation: Radiologische Klinik, Universitätsklinikum, Siegmund-Freud-Str. 25, 53105, Bonn, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Rauch
authors.affiliation: Radiologische Klinik, Universitätsklinikum, Siegmund-Freud-Str. 25, 53105, Bonn, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Henseler
authors.affiliation: Radiologische Klinik, Universitätsklinikum, Siegmund-Freud-Str. 25, 53105, Bonn, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Clarens
authors.affiliation: Radiologische Klinik, Universitätsklinikum, Siegmund-Freud-Str. 25, 53105, Bonn, Deutschland.
authors.forename: L
authors.initials: L
authors.lastname: Brüx
authors.affiliation: Institut für Klinische Chemie und Pharmakologie, Universitätsklinikum, Bonn, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Dolscheid-Pommerich
authors.affiliation: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum, Bonn, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Conrad
authors.affiliation: Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum, Bonn, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Cuhls
authors.affiliation: Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum, Bonn, Deutschland.
authors.forename: L
authors.initials: L
authors.lastname: Radbruch
authors.affiliation: Radiologische Klinik, Universitätsklinikum, Siegmund-Freud-Str. 25, 53105, Bonn, Deutschland.
authors.forename: H H
authors.initials: HH
authors.lastname: Schild
authors.affiliation: Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum, Bonn, Deutschland.|Institut für Hausarztmedizin, Universitätsklinikum, Bonn, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Mücke
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000072716:Cancer Pain / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy*; D011795:Surveys and Questionnaires
keywords: High-intensity focused ultrasound; Pain relief; Pain sensation scale; Pancreatic cancer; Tumor pain