Purpose: To compare the survival benefit and safety of the low power cumulative and traditional high intensity focused ultrasound (HIFU) for locally advanced pancreatic cancer.
Method: We retrospectively analyzed 38 patients with locally advanced, inoperable, stage III pancreatic patients received HIFU treatment between January 2008 and April 2014 in the Department of Surgery, the Second Affiliated Hospital, Zhejiang University, School of Medicine. 11 of them received the low power cumulative HIFU treatment, while other 27 received the traditional HIFU treatment. The HIFU device used was the FEP-BY02 (Yuande Biomedical Engineering Co. Ltd, Beijing, China). Serum biochemistry and adverse events were assessed before and after treatment. All the patients were followed up until death. The survival rate and adverse events of two groups were compared.
Results: In 38 patients, the baseline characteristics including gender, age, Karnofsky performance status (KPS) score, tumor location of two groups were generally well balanced (P > 0.05). The median overall survival (OS) for low power cumulative HIFU group was 10.3 months (95% CI, 6.3-14.3 months), which is significantly longer than traditional HIFU group with 6.0 months (95% CI, 5.2-6.8 months) (P = 0.018). In low power cumulative HIFU group, the 6-month and 12-month survival rates were higher than traditional group, 100% v.s 44.4%, 11.1% v.s 36.4%, respectively. The adverse events in both groups include abdominal pain, fever, C-reactive protein (CRP) elevated. The incidence was lower in low power cumulative HIFU group, however, without statistical significance.
Conclusion: The low power cumulative HIFU treatment showed a statistical significance in survival benefit with better safety profile compared to the traditional HIFU treatment in patients with locally advanced pancreatic cancer.
Keywords: Efficacy; High intensity focused ultrasound (HIFU); Locally advanced pancreatic cancer; Low power cumulative; Overall survival.