Percutaneous ultrasonography and computed tomography guided pancreatic cryoablation: feasibility and safety assessment

Cryobiology. 2012 Dec;65(3):301-7. doi: 10.1016/j.cryobiol.2012.08.004. Epub 2012 Aug 31.

Abstract

Objective: To assess the safety and feasibility of percutaneous cryoablation on pancreatic cancer via ultrasonography (US) and computed tomography (CT) guidance.

Materials and methods: This retrospective review was approved by the institutional review board and of informed consent. Thirty-two patients (18 men and 14 women; median age 62; age range, 30-77 years) with pancreatic cancer (stage II/III/IV, 3/11/18) treated with percutaneous US and CT guided cryoablations between February 2009 and February 2010 were eligible for this review. Thirteen tumors in pancreatic head and 19 in pancreatic body and/or tail measuring 2-11 cm (mean, 5.2 cm±8 [standard deviation]) were ablated with 49 procedures in total. Feasibility was analyzed by enhanced CT 1-3 months post procedure and safety was assessed by clinical signs, symptoms and laboratory results.

Results: Neither procedural death nor serious complications occurred. Fifteen tumors (46.9%) smaller than 5 cm were successfully ablated by one session of cryoablation. Twenty-seven patients experienced a ≥50% reduction in pain score, 22 experienced a 50% decrease in analgesic consumption and 16 experienced a ≥20 increase in Karnofsky Performance Status (KPS) Score. Partial response (PR) and stable disease (SD) turned up in 9 and 21 patients, respectively, lesions in whom were identified controlled by none enhancement on enhanced CT. Mean and median survival was 15.9 and 12.6 months, respectively. The 6-, 12- and 24-month survival rates were 82.8%, 54.7% and 27.3%, respectively.

Conclusion: US and CT guided percutaneous cryoablation is a safe and promising local treatment for pancreatic cancer.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brachytherapy
  • Cryosurgery / adverse effects
  • Cryosurgery / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pancreas / diagnostic imaging
  • Pancreas / pathology*
  • Pancreas / radiation effects
  • Pancreas / surgery*
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / radiotherapy
  • Pancreatic Neoplasms / surgery*
  • Survival Analysis
  • Tomography, X-Ray Computed
  • Ultrasonography