Therapeutic ultrasound in pancreatic adenocarcinoma - Archive ouverte HAL Accéder directement au contenu
Communication Dans Un Congrès Année : 2015

Therapeutic ultrasound in pancreatic adenocarcinoma

Résumé

Background There are over 217 000 new cases of pancreatic cancer each year. Pancreatic cancer is very difficult to treat due to aggressive biology, late diagnosis, encasement of large blood vessels and/or the presence of metastasis; hence surgery is rarely an option. Chemotherapy produces modest responses but is not curative in this setting, mainly because its use is severely hampered by toxic effects to vital organs. As a result, the survival is very low. The mortality of the inoperable patients is 50% within 3 months and 90% within 12 months Objectives The aims of this Phase I study were to investigate the safety and the ability of inducing sonoporation in a clinical setting, using commercially available technology, to increase the patients’ treatment cycles and to possibly increase the overall survival in patients with pancreatic adenocarcinoma. Methods 10 Patients were treated using a customized configuration of a commercial clinical ultrasound scanner (GE LOGIQ 9) over a time period of 31.5 min following standard chemotherapy treatment with gemcitabine. SonoVue was injected intravenously during the treatment with the aim of inducing sonoporation. To ensure microbubbles were present throughout the whole treatment, 0.5 ml of contrast agent followed by 5 ml saline were injected every 3.5 min, i.e., at T = 30.0, 33.5, 37.0, 40.5, 44.0, 47.5, 51.0, 54.5, and 58.0min. A single vial (4.5 ml) was used throughout each treatment. Treatment was stopped at T=61.5 min. The total cumulated ultrasound treatment time was only 18.9 s. Gemcitabine was administered by intravenous infusion at a dose of 1000 mg/m2 over 30 min. Results Using the authors’ custom acoustic settings, the 10 patients were able to undergo an increased number of treatment cycles; from an average of 8 cycles, to an average of 14 cycles when comparing to a historical control group of 80 patients. In the first two out of five patients treated (published data, ref below), the maximum tumor diameter was temporally decreased to 80 ± 5% and permanently to 70 ± 5% of their original size, while the other patients showed reduced growth. Compared to historical data, there was increased survival with 60% of patients surviving 12 months. Conclusions It is feasible to combine ultrasound, microbubbles, and chemotherapy in a clinical setting using a commercially available clinical ultrasound scanner to increase the number of treatment cycles. Our study also indicates increased survival in patients with inoperable pancreatic adenocarcinoma. Reference Medical Physics, Vol. 40, No. 7, July 2013 DOI: 10.1118/1.4808149
Fichier non déposé

Dates et versions

Identifiants

Citer

Spiros Kotopoulis, Georg Dimcevski, Dag Hoem, Michiel Postema, Odd Helge Gilja. Therapeutic ultrasound in pancreatic adenocarcinoma. The 20th European Symposium on Ultrasound Contrast Imaging, Jan 2015, Rotterdam, Netherlands. pp.28-29, ⟨10.5281/zenodo.4770774⟩. ⟨hal-03195142⟩
22 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More