Focused ultrasound and concurrent chemotherapy for the treatment of advanced pancreatic cancer: A systematic review

• Published in: Journal of surgical oncology Vol. 130; no. 8; pp. 1617 - 1623
• Main Authors: Bennett, Sean, Hirpara, Dhruvin H., Raphael, Michael, Karanicolas, Paul J.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.12.2024; John Wiley and Sons Inc
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer therapies; Chemotherapy; Combined Modality Therapy; focused ultrasound; Hepatobiliary, Pancreas; Humans; Pancreatic cancer; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - therapy; systematic review; Ultrasonic imaging; Ultrasonic Therapy - methods; pancreatic cancer; systematic review; chemotherapy; focused ultrasound
• DOI: 10.1002/jso.27832
• ISSN: 0022-4790; 1096-9098

Background and Objectives The combination of focused ultrasound (FUS) and chemotherapy is a novel treatment for pancreatic cancer. This paper reviews the literature on this combined therapy. Methods The medical literature was searched according to PRISMA guidelines. Inclusion criteria were any study of patients with pancreatic cancer undergoing treatment with FUS and chemotherapy. Data extracted included stage, radiologic response, resection rate, survival, and adverse events. Results The initial search yielded 212 citations; 10 studies met inclusion criteria (9 retrospective cohorts; 1 randomized trial). A total of 631 patients received FUS + chemotherapy; 63.6% being stage 4, and 29.7% stage 3. Patient selection, FUS parameters, and chemotherapy used were all heterogeneous. Overall survival ranged from 7.4 to 21.6 months, radiologic response rate was 44.1%, and 24.4% of stage 3 patients underwent resection. All four studies with a comparison group demonstrated improved survival. FUS + chemotherapy decreased pain in 69.7% of patients. Severe adverse events occurred in 0.65%. Conclusions The literature on combined FUS and chemotherapy for pancreatic cancer is heterogeneous. There is good evidence that adverse events are low, and that it provides effective palliation. There is evidence to suggest oncologic benefit, however, this is subject to selection bias and prospective trials are needed.