Feasibility and safety of percutaneous cryoablation for locally advanced pancreatic cancer
10.3760/cma.j.issn.1674-1935.2011.01.001
- VernacularTitle:经皮冷消融治疗局部进展性胰腺癌的可行性
- Author:
Lizhi NIU
;
Haibo LI
;
Weifeng WEN
;
Yong HU
;
Binghui WU
;
Bing LIANG
;
Rongrong LI
;
Liang ZHOU
;
Jing WANG
;
Daming YANG
;
Kecheng XU
- Publication Type:Journal Article
- Keywords:
Pancreatic neoplasms;
Cryotherapy;
Cryoablation;
Ultrasonography imaging
- From:
Chinese Journal of Pancreatology
2011;11(1):1-4
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the adverse reaction, tumor response and short term outcomes of percutaneous cryoablation for locally advanced pancreatic cancer, and investigate its feasibility. Methods Fifty-nine consecutive patients with locally advanced, unresectable pancreatic cancer underwent percutaneous cryoablation at our hospital from Sept. 2008 to Sept. 2009, were prospectively studied. Percutaneous cryoablation was performed with an argon/helium-based cryosurgical system under the guidance of ultrasound.Freezing probe was inserted into the center of pancreatic mass and two cycles of freezing were performed with each cycle for 5 min and temperature at-160℃, then the temperature was returned to normal for 10 min.Serum amylase was detected before operation and 1 to 7 days postoperatively. CT or PET-CT scanning was performed for evaluation of tumor response every 4 to 6 weeks after cryoablation. Survival was assessed by Kaplan-Meier method. Results 59 patients had a total of 76 biopsy-proven tumors, which were located at the pancreas head (n = 56), body (n = 7), and tail (n = 13). The median size of tumor was 4.5 cm (range 3 ～6 cm). Nineteen patients had liver metastases. Postoperative abdominal pain occurred in 45 cases (76.3%),fever occurred in 29 cases (49.2%) and elevation of serum amylase occurred in 34 cases (57.6%). Severe complications including intra-abdominal bleeding, pancreatic leaks, ileus, and metastasis by probe tract occurred in 5 cases (8.5%). There was no death associated with cryoablation. The median hospital stay was 21 days. 2 patients (3.4%) achieved complete response, 23 patients (39.0%) achieved partial response,30patients (50.8%) had stable disease, 4 patients(6.8%) had progressive disease. The median survival was 8.4 months. The overall survival at 3, 6 and 12 months was 89.7%, 61.1% and 34.5%, respectively.Conclusions Ultrasound-guided percutaneous cryoablation appears to be a safe and feasible, minimally invasive technique for locally advanced pancreatic cancer.
