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Статті в журналах з теми "Pancreatic cancer, Radiofrequency ablation, immunity"

Автор: Grafiati

Опубліковано: 11 березня 2023

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1

Jarosova, Jana, Peter Macinga, Lenka Krupickova, Martina Fialova, Alzbeta Hujova, Jan Mares, Ondrej Urban, et al. "Impact of Endoluminal Radiofrequency Ablation on Immunity in Pancreatic Cancer and Cholangiocarcinoma." Biomedicines 10, no. 6 (June 6, 2022): 1331. http://dx.doi.org/10.3390/biomedicines10061331.

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Radiofrequency ablation (RFA) is a mini-invasive loco-regional ablation technique that is increasingly being used as a palliative treatment for pancreatic cancer and cholangiocarcinoma. Ablation-triggered immune system stimulation has been proposed as a mechanism behind the systemic effects of RFA. The aim of our study was to investigate the immune response to endoluminal biliary RFA. Peripheral blood samples were collected from patients with pancreatic cancer and cholangiocarcinoma randomised to receive endoluminal biliary radiofrequency ablation + stent (19 patients) or stent only (21 patients). We observed an early increase in IL-6 levels and a delayed increase in CXCL1, CXCL5, and CXCL11 levels as well as an increase in CD8+ and NK cells. However, these changes were not specific to RFA treatment. Explicitly in response to RFA, we observed a delayed increase in serum CXCL1 levels and an early decrease in the number of anti-inflammatory CD206+ blood monocytes. Our study provides the first evidence of endoluminal biliary RFA-based regulation of the systemic immune response in patients with pancreatic cancer and cholangiocarcinoma. These changes were characterised by a general inflammatory response. RFA-specific activation of the adaptive immune system was not confirmed.

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2

Giardino, A., R. Girelli, I. Frigerio, P. Regi, F. Scopelliti, O. Perbellini, G. Innamorti, M. Bacchion, P. Pederzoli, and C. Bassi. "Immunity stimulation after radiofrequency ablation of locally advanced pancreatic cancer: Preliminary results." HPB 18 (April 2016): e760. http://dx.doi.org/10.1016/j.hpb.2016.01.265.

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3

Hadjicostas, P., N. Malakounides, C. Varianos, E. Kitiris, F. Lerni, and P. Symeonides. "Radiofrequency ablation in pancreatic cancer." HPB 8, no. 1 (February 2006): 61–64. http://dx.doi.org/10.1080/13651820500466673.

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4

Sarno, Alessandro, Alessandro Beleù, Riccardo De Robertis, Gabriele Giannotti, Giorgia Tedesco, Salvatore Paiella, and Mirko D'Onofrio. "Radiofrequency Ablation of Pancreatic Cancer." Digestive Disease Interventions 03, no. 02 (May 10, 2019): 133–37. http://dx.doi.org/10.1055/s-0039-1688437.

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AbstractRadiofrequency ablation (RFA) is emerging as a safe and feasible technique to treat various pancreatic lesions. In particular, pancreatic ductal adenocarcinoma (PDAC) is the most frequent treated lesion. Nowadays, PDAC treatment by means of RFA is limited to locally advanced, non-resectable, but non-metastatic lesions. The aim of this article is to describe the RFA technique, its results and possible complications.

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5

Hlavsa, J., V. Procházka, Z. Kala, T. Andrašina, B. Hemmelová, T. Pavlík, I. Penka, et al. "Radiofrequency ablation of pancreatic cancer." Pancreatology 12, no. 6 (November 2012): 586. http://dx.doi.org/10.1016/j.pan.2012.11.287.

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6

Chen, Sheng-Yang, and Xiao-Yong Li. "Radiofrequency ablation for unresectable pancreatic cancer." World Chinese Journal of Digestology 21, no. 31 (2013): 3383. http://dx.doi.org/10.11569/wcjd.v21.i31.3383.

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7

Logue, Jennifer, Edward Leen, Susan J. Moug, Ross Carter, and Colin McKay. "M1550 Radiofrequency Ablation of Locally Advanced Pancreatic Cancer." Gastroenterology 134, no. 4 (April 2008): A—871. http://dx.doi.org/10.1016/s0016-5085(08)64082-2.

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8

Giardino, A., G. Innamorati, R. Girelli, I. Frigerio, P. Regi, F. Scopelliti, S. Paiella, P. Pederzoli, C. Bassi, and G. Butturini. "Radiofrequency ablation of locally advanced pancreatic cancer: immunostimulation patterns." HPB 21 (2019): S977—S978. http://dx.doi.org/10.1016/j.hpb.2019.10.1287.

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9

Giardino, A., G. Innamorati, R. Girelli, I. Frigerio, P. Regi, F. Scopelliti, S. Paiella, P. Pederzoli, C. Bassi, and G. Butturini. "Radiofrequency ablation of Locally Advanced Pancreatic Cancer: Immunostimulation Patterns." HPB 21 (2019): S766. http://dx.doi.org/10.1016/j.hpb.2019.10.1523.

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10

Zou, Yi-Ping. "Intraoperative radiofrequency ablation combined with125iodine seed implantation for unresectable pancreatic cancer." World Journal of Gastroenterology 16, no. 40 (2010): 5104. http://dx.doi.org/10.3748/wjg.v16.i40.5104.

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11

Fegrachi, Samira, Marc G. Besselink, Hjalmar C. van Santvoort, Richard van Hillegersberg, and Izaak Quintus Molenaar. "Radiofrequency ablation for unresectable locally advanced pancreatic cancer: a systematic review." HPB 16, no. 2 (February 2014): 119–23. http://dx.doi.org/10.1111/hpb.12097.

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12

Rombouts, Steffi J. E., Tyche C. Derksen, Chung Y. Nio, Richard van Hillegersberg, Hjalmar C. van Santvoort, Marieke S. Walma, Izaak Q. Molenaar, and Maarten S. van Leeuwen. "Computed tomography findings after radiofrequency ablation in locally advanced pancreatic cancer." Abdominal Radiology 43, no. 10 (February 28, 2018): 2702–11. http://dx.doi.org/10.1007/s00261-018-1519-y.

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13

D’Onofrio, Mirko, Stefano Crosara, Riccardo De Robertis, Giovanni Butturini, Roberto Salvia, Salvatore Paiella, Claudio Bassi, and Roberto Pozzi Mucelli. "Percutaneous Radiofrequency Ablation of Unresectable Locally Advanced Pancreatic Cancer: Preliminary Results." Technology in Cancer Research & Treatment 16, no. 3 (May 18, 2016): 285–94. http://dx.doi.org/10.1177/1533034616649292.

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Анотація:

Aim: The objective of this study was to evaluate the efficacy of percutaneous radiofrequency ablation of locally advanced pancreatic cancer located in the pancreatic body. Materials and Methods: Patients with biopsy-proven locally advanced pancreatic adenocarcinoma were considered for percutaneous radiofrequency ablation. Postprocedural computed tomography studies and Ca19.9 tumor marker evaluation were performed at 24 hours and 1 month. At computed tomography, treatment effect was evaluated by excluding the presence of complications. The technical success of the procedure is defined at computed tomography as the achievement of tumoral ablated area. Results: Twenty-three patients have been included in the study. Five of the 23 patients were excluded. At computed tomography, the mean size of the intralesional postablation necrotic area was 32 mm (range: 15-65 mm). Technical success of the procedure has been obtained in 16 (93%) of the 18 cases. None of the patients developed postprocedural complications. Mean Ca19.9 serum levels 1 day before, 1 day after, and 1 month after the procedure were 285.8 U/mL (range: 16.6-942.0 U/mL), 635.2 U/mL (range: 17.9-3368.0 U/mL), and 336.0 U/mL (range: 7.0-1400.0 U/mL), respectively. Follow-up duration was less than 6 months for 11 patients and more than 6 months for 7 patients. At the time of the draft of this article, the mean survival of the patients included in the study was 185 days (range: 62-398 days). Conclusion: Percutaneous radiofrequency ablation of locally advanced adenocarcinoma has a high technical success rate and is effective in cytoreduction both at imaging and laboratory controls.

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14

Fegrachi, S., S. Rombouts, Q. Molenaar, R. van Hillegersberg, H. van Santvoort, J. de Vries, M. van Leeuwen, et al. "Safety of radiofrequency ablation in patients with locally irresectable pancreatic cancer." HPB 18 (April 2016): e355. http://dx.doi.org/10.1016/j.hpb.2016.02.922.

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15

Song, Tae Jun, Dong Wan Seo, Sundeep Lakhtakia, Nageshwar Reddy, Dong Wook Oh, Do Hyun Park, Sang Soo Lee, Sung Koo Lee, and Myung-Hwan Kim. "Initial experience of EUS-guided radiofrequency ablation of unresectable pancreatic cancer." Gastrointestinal Endoscopy 83, no. 2 (February 2016): 440–43. http://dx.doi.org/10.1016/j.gie.2015.08.048.

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16

Girelli, R., I. Frigerio, R. Salvia, E. Barbi, P. Tinazzi Martini, and C. Bassi. "Feasibility and safety of radiofrequency ablation for locally advanced pancreatic cancer." British Journal of Surgery 97, no. 2 (January 12, 2010): 220–25. http://dx.doi.org/10.1002/bjs.6800.

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17

Changela, Kinesh, Rashmee Patil, Sushil Duddempudi, and Vinaya Gaduputi. "Endoscopic Ultrasound-Guided Radiofrequency Ablation of the Pancreatic Tumors: A Promising Tool in Management of Pancreatic Tumors." Canadian Journal of Gastroenterology and Hepatology 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/4189358.

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Анотація:

Objective. Radiofrequency ablation is a well-established antitumor treatment and is recognized as one of the least invasive therapeutic modalities for pancreatic neoplasm. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) delivery can be used to treat both pancreatic cancer and asymptomatic premalignant pancreatic neoplasms and may serve as a less invasive alternative to surgical resection. This is an appealing option that may result in less morbidity and mortality. The aim of this review was to summarize and evaluate the clinical and technical effectiveness of EUS-guided RFA of pancreatic neoplasms.Methods. A through literature review was performed to identify the studies describing this novel technique. In this review article, we have summarized human case series. The indications, techniques, limitations, and complications reported are discussed.Results. A total of six studies were included. Overall, a 100% technical success rate was reported in human studies. Complications related to endoscopic ultrasound-guided radiofrequency ablation delivery have been described; however, few cases have presented life-threatening outcomes.Conclusion. We believe that this novel technique can be a safe and effective alternative approach in the management of selected patients.

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18

Vetshev, P. S., A. V. Chzhao, D. A. Ionkin, Yu A. Stepanova, O. I. Zhavoronkova, Yu V. Kulezneva, O. V. Melekhina, et al. "Minimally invasive technologies for ablation of pancreatic malignancies." Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery 24, no. 3 (September 22, 2019): 87–98. http://dx.doi.org/10.16931/1995-5464.2019387-98.

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Minimally invasive ablative technologies is a promising direction in the treatment of some cancer patients including pancreatic cancer. Cryodestruction, radiofrequency ablation, irreversible electroporation and ultrasound ablation show encouraging results regarding destruction of tumor tissue, cytoreduction. These methods are associated with small number of complications and relatively easy to tolerate by patients. However, there is no single approach to their use in the complex treatment of these patients. Accumulation of data followed by comparative analysis of various ablation techniques is being carried out in many specialized clinics of the world including national hospitals. Ablation mechanisms of technologies, literature data and the authors' own experience in the treatment of pancreatic cancer are reported in the article. Further randomized prospective trials are required to determine the role of ablation methods in the complex treatment of tumors of parenchymal organs including pancreatic cancer.

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19

Paiella, Salvatore, Matteo De Pastena, Mirko D’Onofrio, Stefano Francesco Crinò, Teresa Lucia Pan, Riccardo De Robertis, Giovanni Elio, Enrico Martone, Claudio Bassi, and Roberto Salvia. "Palliative therapy in pancreatic cancer—interventional treatment with radiofrequency ablation/irreversible electroporation." Translational Gastroenterology and Hepatology 3 (October 2018): 80. http://dx.doi.org/10.21037/tgh.2018.10.05.

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20

Ikuta, Shinichi. "Optimal combination of radiofrequency ablation with chemoradiotherapy for locally advanced pancreatic cancer." World Journal of Clinical Oncology 3, no. 1 (2012): 12. http://dx.doi.org/10.5306/wjco.v3.i1.12.

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21

Wang, Katherine M., Aamir Dam, and Micheal S. Tadros. "Radiofrequency Ablation for Radiation Gastritis/Duodenitis in the Setting of Pancreatic Cancer." American Journal of Gastroenterology 111 (October 2016): S717. http://dx.doi.org/10.14309/00000434-201610001-01549.

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22

Song, Tae Jun, Dong Wan Seo, Sundeep Lakhtakia, Nageshwar D. Reddy, Dongwook Oh, Do Hyun Park, Sang Soo Lee, Sung Koo Lee, and Myung-Hwan Kim. "Tu1628 Initial Experiences of EUS-Guided Radiofrequency Ablation of Unresectable Pancreatic Cancer." Gastrointestinal Endoscopy 81, no. 5 (May 2015): AB536. http://dx.doi.org/10.1016/j.gie.2015.03.1080.

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23

Brauer, Brian C. "Intraductal Radiofrequency Ablation (RFA) for Pancreatic Cancer: Getting in Under the Wire?" Digestive Diseases and Sciences 60, no. 11 (July 25, 2015): 3160–61. http://dx.doi.org/10.1007/s10620-015-3811-9.

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24

Haen, Sebastian P., Philippe L. Pereira, Helmut R. Salih, Hans-Georg Rammensee, and Cécile Gouttefangeas. "More Than Just Tumor Destruction: Immunomodulation by Thermal Ablation of Cancer." Clinical and Developmental Immunology 2011 (2011): 1–19. http://dx.doi.org/10.1155/2011/160250.

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Over the past decades, thermoablative techniques for the therapy of localized tumors have gained importance in the treatment of patients not eligible for surgical resection. Anecdotal reports have described spontaneous distant tumor regression after thermal ablation, indicating a possible involvement of the immune system, hence an induction of antitumor immunity after thermoinduced therapy. In recent years, a growing body of evidence for modulation of both adaptive and innate immunity, as well as for the induction of danger signals through thermoablation, has emerged. Induced immune responses, however, are mostly weak and not sufficient for the complete eradication of established tumors or durable prevention of disease progression, and combination therapies with immunomodulating drugs are being evaluated with promising results. This article aims to summarize published findings on immune modulation through radiofrequency ablation, cryoablation, microwave ablation therapy, high-intensity focused ultrasound, and laser-induced thermotherapy.

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25

Spiliotis, John. "Commentary on Pancreatic Carcinoma: The Role of Radiofrequency Ablation in Advanced Disease." Cancers 2, no. 4 (December 8, 2010): 2055–57. http://dx.doi.org/10.3390/cancers2042055.

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26

Paiella, Salvatore, Roberto Salvia, Marco Ramera, Roberto Girelli, Isabella Frigerio, Alessandro Giardino, Valentina Allegrini, and Claudio Bassi. "Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation): A Review." Gastroenterology Research and Practice 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/4508376.

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Pancreatic ductal adenocarcinoma (PDAC) has still a dismal prognosis. Locally advanced pancreatic cancer (LAPC) accounts for the 40% of the new diagnoses. Current treatment options are based on chemo- and radiotherapy regimens. Local ablative techniques seem to be the future therapeutic option for stage-III patients with PDAC. Radiofrequency Ablation (RFA) and Irreversible Electroporation (IRE) are actually the most emerging local ablative techniques used on LAPC. Initial clinical studies on the use of these techniques have already demonstrated encouraging results in terms of safety and feasibility. Unfortunately, few studies on their efficacy are currently available. Even though some reports on the overall survival are encouraging, randomized studies are still required to corroborate these findings. This study provides an up-to-date overview and a thematic summary of the current available evidence on the application of RFA and IRE on PDAC, together with a comparison of the two procedures.

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27

Hua, Yong-Qiang, Peng Wang, Xiao-Yan Zhu, Ye-Hua Shen, Kun Wang, Wei-Dong Shi, Jun-Hua Lin, Zhi-Qiang Meng, Zhen Chen, and Hao Chen. "Radiofrequency ablation for hepatic oligometastatic pancreatic cancer: An analysis of safety and efficacy." Pancreatology 17, no. 6 (November 2017): 967–73. http://dx.doi.org/10.1016/j.pan.2017.08.072.

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28

Scopelliti, Filippo, Antonio Pea, Rita Conigliaro, Giovanni Butturini, Isabella Frigerio, Paolo Regi, Alessandro Giardino, et al. "Technique, safety, and feasibility of EUS-guided radiofrequency ablation in unresectable pancreatic cancer." Surgical Endoscopy 32, no. 9 (May 15, 2018): 4022–28. http://dx.doi.org/10.1007/s00464-018-6217-x.

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29

Yang, Jianfeng, and Xiaofeng Zhang. "Tu1357 FEASIBILITY AND SAFETY OF EUS-GUIDED RADIOFREQUENCY ABLATION IN UNRESECTABLE PANCREATIC CANCER." Gastrointestinal Endoscopy 89, no. 6 (June 2019): AB588—AB589. http://dx.doi.org/10.1016/j.gie.2019.03.1014.

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30

Wu, Yulian, Zhe Tang, Heqing Fang, Shunliang Gao, Jian Chen, Yong Wang, and Haichao Yan. "High operative risk of cool-tip radiofrequency ablation for unresectable pancreatic head cancer." Journal of Surgical Oncology 94, no. 5 (2006): 392–95. http://dx.doi.org/10.1002/jso.20580.

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31

John, Spiliotis, Datsis Anastasios, Michalopoulos Nikolaos, Kekelos Spiros, Vaxevanidou Archodia, Rogdakis Athanasios, and Christopoulou Athina. "High operative risk of cool-tip radiofrequency ablation for unresectable pancreatic head cancer." Journal of Surgical Oncology 96, no. 1 (2007): 89–90. http://dx.doi.org/10.1002/jso.20764.

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32

Dumolard, Lucile, Julien Ghelfi, Gael Roth, Thomas Decaens, and Zuzana Macek Jilkova. "Percutaneous Ablation-Induced Immunomodulation in Hepatocellular Carcinoma." International Journal of Molecular Sciences 21, no. 12 (June 20, 2020): 4398. http://dx.doi.org/10.3390/ijms21124398.

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Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide and its incidence is rising. Percutaneous locoregional therapies, such as radiofrequency ablation and microwave ablation, are widely used as curative treatment options for patients with small HCC, but their effectiveness remains restricted because of the associated high rate of recurrence, occurring in about 70% of patients at five years. These thermal ablation techniques have the particularity to induce immunomodulation by destroying tumours, although this is not sufficient to raise an effective antitumour immune response. Ablative therapies combined with immunotherapies could act synergistically to enhance antitumour immunity. This review aims to understand the different immune changes triggered by radiofrequency ablation and microwave ablation as well as the interest in using immunotherapies in combination with thermal ablation techniques as a tool for complementary immunomodulation.

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33

Du, Yu-qing, Xiu-mei Bai, Wei Yang, Zhong-yi Zhang, Song Wang, Wei Wu, Kun Yan, and Min-hua Chen. "Percutaneous ultrasound-guided radiofrequency ablation for patients with liver metastasis from pancreatic adenocarcinoma." International Journal of Hyperthermia 39, no. 1 (March 20, 2022): 517–24. http://dx.doi.org/10.1080/02656736.2022.2048907.

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34

Pezzilli, Raffaele, Claudio Ricci, Carla Serra, Riccardo Casadei, Francesco Monari, Marielda D’Ambra, Roberto Corinaldesi, and Francesco Minni. "The Problems of Radiofrequency Ablation as an Approach for Advanced Unresectable Ductal Pancreatic Carcinoma." Cancers 2, no. 3 (July 1, 2010): 1419–31. http://dx.doi.org/10.3390/cancers2031419.

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35

Lemdani, Katia, Claude Capron, Johanne Seguin, Nathalie Mignet, Vincent Boudy, Frederique Peschaud, Jean Francois Emile, and Robert Malafosse. "The anti-tumour immune response after radiofrequency ablation of colorectal cancer." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e14540-e14540. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e14540.

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e14540 Background: Results of radiofrequency ablation (RFA), increasingly used to treat liver tumors, are compromised by local and systemic relapse. Hyperthermia related cancer cells death, release of tumor antigens and expression of danger signals activate a tumor-specific T-cells response. This effect remains ineffective to avoid recurrence. Therefore we propose to combine RFA with an activation of a solid immune antitumor response as curative treatment of a colorectal (CRC) metastatic disease in immunocompetent mouse. Methods: RFA was used to treat a CT26- luc tumor. In two distinct clinical situations, distant macroscopic or microscopic tumors were established as metastases before or at the time of RFA. Immune response was modulated by an injection in situof a thermo-reversible hydrogel loaded by GM-CSF and BCG, targeting dendritic cells. In the group of mice with large far lesions this strategy was combined with immune checkpoint inhibition. The efficiency was assessed on survival, evolution of distant lesions, characterization of lymphocyte infiltration in tumors and systemic immunity through specific TNF- α and IFN-y expression in spleen and draining lymph nodes. Results: The in situ immunogel injection after RFA resulted in a prolonged survival of mice. Regression of distant lesions was related to a strong systemic antitumor immune response and a great improvement of tumor infiltration by specific cytotoxic lymphocytes. In adjuvant situation, the use of immunogel induced a complete cure of microscopic secondary lesions without any treatment. Immune escape of large secondary lesions was reversed by association of RFA-immunogel vaccination with a systemic check point blockade, separately ineffective. Conclusions: Validation of this strategy, combining RFA of liver metastases and activation of a strong immune response controlling the residual disease, could result in a clinical assay including this approach within the standard treatment of CRC. Furthermorethe powerful synergy between RFA-in situ immunomodulation as a starter treatment and checkpoint blockade ineffective alone in CRC or after single RFA, allows reconsidering the use of immune checkpoint inhibitors in metastatic microsatellite stable CRC.

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36

Hendricks, Alissa Danielle, Jaqueline Sereno, Jessica Gannon, Allison Zeher, Rebecca M. Brock, Natalie Betiel-White, Alexander Simon, et al. "Histotripsy ablation stimulates the innate immune system and modulates anti-tumor immunity in pancreatic cancer." Journal of Immunology 206, no. 1_Supplement (May 1, 2021): 56.05. http://dx.doi.org/10.4049/jimmunol.206.supp.56.05.

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Abstract With an overall 5-year survival rate of less than 9%, pancreatic cancer is a substantial cause of cancer related death in the United States. This high mortality has been associated with the immunosuppressive tumor microenvironment (TME) and the shortage of effective late-stage therapeutic options. Histotripsy is a non-thermal, non-ionizing, non-invasive cancer ablation modality that rapidly lyses targeted cells. To investigate how histotripsy can change the pancreatic TME, a Pan02 cell culture model of pancreatic adenocarcinoma was employed to determine the neoantigen release following histotripsy treatment and other standard ablation modalities. Histotripsy was found to release potential neoantigens at a level similar to other non-thermal ablations and superior to thermal ablation, which paralleled the increased innate immune system activation in vivo. For in vivo studies, subcutaneous Pan02 tumors in mice were treated with histotripsy. To monitor changes in the TME after treatment, rtPCR and flow cytometry were used and compared to untreated animals. Progression-free and overall survival were significantly improved with histotripsy treatment. Within 24 hours of treatment there was increased activation of the innate immune system and by 14 days there were decreased tumor-associated immune cell populations. This work illustrates the feasibility of using histotripsy to treat pancreatic cancer and shift the TME as well as providing mechanistic understanding into the activation of the innate immune system post-treatment. Future studies are needed to establish the mechanism of immunomodulation of the TME and the extent of potential systemic effects.

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37

Salahia, Ghali, Sook Cheng Chin, Ian Zealley, and Richard D. White. "The Role of Interventional Radiology in the Management of Pancreatic Pathologies." Journal of Gastrointestinal and Abdominal Radiology 3, no. 01 (January 2020): 099–113. http://dx.doi.org/10.1055/s-0039-3401335.

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AbstractPancreatic pathologies are varied and wide-ranging, and a multidisciplinary approach is essential for effective diagnosis and management. We describe image-guided percutaneous (nonendoscopic) interventions in the management of pancreatic disease, with emphasis on inflammatory and neoplastic pancreatic pathologies and on the transplanted pancreas. Image-guided treatments for the complications of pancreatitis include percutaneous interventions on simple and complex peripancreatic collections, pseudocysts, and fistulas. Vascular interventions predominantly focus on the treatment of pseudoaneurysms, hemorrhagic pseudocysts, and arteriovenous malformations. Emerging ablative techniques for pancreatic cancer are promising and include percutaneous radiofrequency ablation, microwave ablation, irreversible electroporation, and electrochemotherapy. Image-guided interventions on the transplanted pancreas commonly include percutaneous biopsy and drainage in addition to endovascular treatments of vascular complications.

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Walma, Marieke S., Jantien A. Vogel, Eran van Veldhuisen, Olivier R. Busch, J. W. Wilmink, Hjalmar C. van Santvoort, Marc G. Besselink, I. Q. Molenaar, and Krijn P. van Lienden. "Radiofrequency ablation and irreversible electroporation in locally advanced pancreatic cancer: Competitive or complementary treatment modalities?" Pancreatology 18, no. 4 (June 2018): S134—S135. http://dx.doi.org/10.1016/j.pan.2018.05.362.

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39

Walma, M., J. Vogel, E. van Veldhuisen, O. Busch, H. Wilmink, H. van Santvoort, M. Besselink, Q. Molenaar, and K. van Lienden. "Radiofrequency ablation and irreversible electroporation in locally advanced pancreatic cancer: competitive or complementary treatment modalities?" HPB 20 (September 2018): S573—S574. http://dx.doi.org/10.1016/j.hpb.2018.06.2059.

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40

Ehsan, Hamid, Adeel Masood, Ahsan Wahab, Zahoor Ahmed, Diana Franco, Abdul Rafae, and Muhammad Nadeem Yousaf. "Efficacy and the safety of endoscopic ultrasound guided radiofrequency ablation of pancreatic cancer: A systematic review and meta-analysis." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e16276-e16276. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e16276.

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e16276 Background: Endoscopic ultrasound-guided RFA (EUS-RFA) is a minimally invasive emerging modality that may be an alternative to surgical resection for the management of unresectable pancreatic cancer (UPC). In this review, we highlighted the efficacy, clinical and technical success of the EUS-RFA for UPC. Methods: Studies were selected with a comprehensive search strategy for EUS-RFA and pancreatic cancer on PubMed, Google Scholar, and Embase databases as of October 2021. The primary outcomes were the technical (TS) and clinical success rate (CS) of the EUS-RFA procedure, while the secondary outcome was the adverse events (AEs) rate. Results: Twelve studies including 114 patients with 50% (57) females were included. Common pancreatic tumors were locally advanced pancreatic ductal adenocarcinoma (LAPDAC) 38.3% (49), followed by nonfunctional neuroendocrine tumor (NNET) 32% (41), pancreatic cystic neoplastic lesions 14.8% (19), insulinoma 12.5% (16) and others 2.3% (3). The most common site of the tumor was pancreatic head 45.7% (59) followed by body, neck, and tail 47.6% (61). The average number of ablation sessions per patient was 1.4 based on the total of 115 EUS-RFA sessions performed in 84 neoplastic lesions. The pooled TS rate of EUS-RFA calculated from the total number of procedures was 99.2% [95% CI = 0.90-0.98, I2 = 0%]. The pooled CS rate calculated from the total number of pancreatic lesions was 91.9% [95% CI = 0.77-0.92, I2 = 0%]. Clinical improvement in symptoms was reported in five studies whereas complete resolution or decrease in tumor size was reported in all studies. The pooled AEs rate was 24.6% [95% CI = 0.17-0.39, I2 = 30%]. Common AEs were abdominal pain 10.5% (12), and pancreatitis 3.5% (4). Conclusions: EUS-RFA is a promising and safe modality that can be used for the management of UPC in selected patients with a high TS (99.2%) and CS rates (91.9%). Large clinical trials are needed to identify safety, clinical outcomes, and overall survival benefits of EUS-RFA.[Table: see text]

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Ehsan, Hamid, Adeel Masood, Ahsan Wahab, Zahoor Ahmed, Diana Franco, Abdul Rafae, and Muhammad Nadeem Yousaf. "Efficacy and the safety of endoscopic ultrasound guided radiofrequency ablation of pancreatic cancer: A systematic review and meta-analysis." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e16276-e16276. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e16276.

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e16276 Background: Endoscopic ultrasound-guided RFA (EUS-RFA) is a minimally invasive emerging modality that may be an alternative to surgical resection for the management of unresectable pancreatic cancer (UPC). In this review, we highlighted the efficacy, clinical and technical success of the EUS-RFA for UPC. Methods: Studies were selected with a comprehensive search strategy for EUS-RFA and pancreatic cancer on PubMed, Google Scholar, and Embase databases as of October 2021. The primary outcomes were the technical (TS) and clinical success rate (CS) of the EUS-RFA procedure, while the secondary outcome was the adverse events (AEs) rate. Results: Twelve studies including 114 patients with 50% (57) females were included. Common pancreatic tumors were locally advanced pancreatic ductal adenocarcinoma (LAPDAC) 38.3% (49), followed by nonfunctional neuroendocrine tumor (NNET) 32% (41), pancreatic cystic neoplastic lesions 14.8% (19), insulinoma 12.5% (16) and others 2.3% (3). The most common site of the tumor was pancreatic head 45.7% (59) followed by body, neck, and tail 47.6% (61). The average number of ablation sessions per patient was 1.4 based on the total of 115 EUS-RFA sessions performed in 84 neoplastic lesions. The pooled TS rate of EUS-RFA calculated from the total number of procedures was 99.2% [95% CI = 0.90-0.98, I2 = 0%]. The pooled CS rate calculated from the total number of pancreatic lesions was 91.9% [95% CI = 0.77-0.92, I2 = 0%]. Clinical improvement in symptoms was reported in five studies whereas complete resolution or decrease in tumor size was reported in all studies. The pooled AEs rate was 24.6% [95% CI = 0.17-0.39, I2 = 30%]. Common AEs were abdominal pain 10.5% (12), and pancreatitis 3.5% (4). Conclusions: EUS-RFA is a promising and safe modality that can be used for the management of UPC in selected patients with a high TS (99.2%) and CS rates (91.9%). Large clinical trials are needed to identify safety, clinical outcomes, and overall survival benefits of EUS-RFA.[Table: see text]

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Gaidhane, Monica, Ioana Smith, Kristi Ellen, Jeremy Gatesman, Nagy Habib, Patricia Foley, Christopher Moskaluk, and Michel Kahaleh. "Endoscopic Ultrasound-Guided Radiofrequency Ablation (EUS-RFA) of the Pancreas in a Porcine Model." Gastroenterology Research and Practice 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/431451.

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Backgrounds. Limited effective palliative treatments exist for pancreatic cancer which includes surgery or chemotherapy. Radiofrequency ablation (RFA) uses high frequency alternating current to ablate diseased tissue and has been used to treat various tumors. In this study, we evaluated a prototype probe adjusted to the EUS-needle to perform EUS-RFA to permit coagulative necrosis in the pancreas.Methods. Five Yucatan pigs underwent EUS-guided radiofrequency ablation of the head of their pancreas. Using an EUS-needle, RFA was applied with 6 mm and then 10 mm of the probe exposed at specific wattage for preset durations.Results. Only one pig showed moderate levels of pancreatitis (20% proximal pancreatitis). The other animals showed much lower areas of tissue damage. In 3 of the 5 pigs, the proximal pancreas showed greater levels of tissue injury than the distal pancreas, consistent with the proximity of the tissue to the procedure site. In 1 pig, both proximal and distal pancreas showed minimal pancreatitis (1%). There was minimal evidence of fat necrosis in intra-pancreatic and/or extra-pancreatic adipose tissue.Conclusion. EUS-guided RFA of the pancreatic head with the monopolar probe through a 19-gauge needle was well tolerated in 5 Yucatan pigs and with minimal amount of pancreatitis.

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Minami, Yasunori, Tomohiro Minami, Hirokazu Chishina, Masashi Kono, Tadaaki Arizumi, Masahiro Takita, Norihisa Yada, et al. "US-US Fusion Imaging in Radiofrequency Ablation for Liver Metastases." Digestive Diseases 34, no. 6 (2016): 687–91. http://dx.doi.org/10.1159/000448857.

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Objective: Radiofrequency ablation (RFA) induces gas bubbles in ablation zones, and the ablative margin cannot be evaluated accurately on ultrasound (US) during and immediately after RFA. This study assessed the usefulness of US-US fusion imaging to visualize the ablative margin of RFA for liver metastasis. Methods: RFA guided by US-US fusion imaging was performed on 12 targeted tumors in 10 patients. Secondary hepatic malignancies included patients with colorectal cancer (n = 4), breast cancer (n = 2), lung cancer (n = 1), gastrointestinal stromal tumor (n = 1), pancreatic neuroendocrine tumor (n = 1), and adrenocortical carcinoma (n = 1). The maximal diameter of the tumors ranged from 0.8 to 4.0 cm (mean ± SD 1.6 ± 0.9 cm). Results: The mean number of electrode insertions was 1.6 per session (range 1-3). Technically, effective ablation was achieved in a single session in all patients, and safety ablative margins were confirmed on contrast-enhanced CT for early assessment of tumor response. There were no serious adverse events or procedure-related complications. During the follow-up period (median 220 days, range 31-417 days), none of the patients showed local tumor progression. Conclusion: US-US fusion imaging could show the tumor images before ablation and the ablative area on US in real time. The image overlay of US-US fusion imaging made it possible to evaluate the ablative margin three dimensionally according to the US probe action. Therefore, US-US fusion imaging can contribute to RFA therapy with a safety margin, that is, the so-called precise RFA.

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Gravis, Gwenaelle, Brice Chanez, Jochen Walz, Jean-Philippe Ratone, Geraldine Pignot, Christian Pesenti, Jeanne Thomassin, et al. "Efficacy and safety of endoscopic radiofrequency ablation for metastatic pancreatic renal cell carcinoma: A monocentric experience." Journal of Clinical Oncology 36, no. 15_suppl (May 20, 2018): e16549-e16549. http://dx.doi.org/10.1200/jco.2018.36.15_suppl.e16549.

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45

Paiella, Salvatore, Roberto Salvia, Roberto Girelli, Isabella Frigerio, Alessandro Giardino, Mirko D’Onofrio, Giulia De Marchi, and Claudio Bassi. "Role of local ablative techniques (Radiofrequency ablation and Irreversible Electroporation) in the treatment of pancreatic cancer." Updates in Surgery 68, no. 3 (August 18, 2016): 307–11. http://dx.doi.org/10.1007/s13304-016-0385-9.

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Stigliano, S., D. Biasutto, and F. M. Di Matteo. "T03.02.19 ENDOSCOPIC ULTRASOUND-GUIDED RADIOFREQUENCY ABLATION OF PANCREATIC METASTASIS FROM RENAL CELL CANCER: FEASIBILITY AND SAFETY." Digestive and Liver Disease 52 (October 2020): S114. http://dx.doi.org/10.1016/s1590-8658(20)30747-7.

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47

Biasutto, Dario, Serena Stigliano, and Francesco M. Di Matteo. "Sa1441 ENDOSCOPIC ULTRASOUND-GUIDED RADIOFREQUENCY ABLATION OF PANCREATIC METASTASES FROM RENAL CELL CANCER: FEASIBILITY AND SAFETY." Gastrointestinal Endoscopy 91, no. 6 (June 2020): AB191—AB192. http://dx.doi.org/10.1016/j.gie.2020.03.1237.

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Gao, Shanshan, Ning Pu, Hanlin Yin, Junhao Li, Qiangda Chen, Minjie Yang, Wenhui Lou, et al. "Radiofrequency ablation in combination with an mTOR inhibitor restrains pancreatic cancer growth induced by intrinsic HSP70." Therapeutic Advances in Medical Oncology 12 (January 2020): 175883592095372. http://dx.doi.org/10.1177/1758835920953728.

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Background: Radiofrequency ablation (RFA) is widely used in palliative therapy of malignant cancers. Several studies have shown its applicability and safety for locally advanced pancreatic cancer (LAPC). The objective of this study was to modify the current regimen to improve its therapeutic effect. Methods: Immune cell subtypes and related cytokines were quantified to uncover the immune pattern changes post-RFA treatment. Then, high-throughput proteome analysis was performed to identify differentially expressed proteins associated with RFA, which were further validated in in vitro and in vivo experiments. Finally, a combined therapy was tested in a murine model to observe its therapeutic effect. Results: In preclinical murine models of RFA treatment, no significant therapeutic benefit was observed following RFA treatment. However, the proportion of tumor-infiltrating CD8+ T cells was significantly increased, whereas that of regulatory T cells (Tregs) was decreased post-RFA treatment, which indicated a beneficial anti-tumor environment. To identify the mechanism, high-throughput mass spectrum was obtained that identified heat shock protein 70 (HSP70) as the top differentially expressed protein. HSP70 expression in residual cancer cells was significantly increased post-RFA treatment, which notably promoted pancreatic cancer growth. Elevated HSP70 promoted cell proliferation by activating AKT–mTOR signaling. Finally, RFA treatment combined with an mTOR inhibitor exerted a synergetic repressive effect on tumor growth in the preclinical murine cancer model. Conclusions: RFA treatment in combination with mTOR signaling blockade can not only promote tumor immune response, but also restrain residual cancer cell proliferation. Such a combination may be a promising and effective therapeutic strategy for LAPC patients.

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Larghi, Alberto, Mihai Rimbaş, and Stefano Francesco Crinò. "EUS-guided radiofrequency ablation of the celiac axis in pancreatic cancer: Is money worth the pain?" Gastrointestinal Endoscopy 89, no. 1 (January 2019): 207. http://dx.doi.org/10.1016/j.gie.2018.08.048.

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Fegrachi, Samira, Marieke S. Walma, Jan J. J. de Vries, Hjalmar C. van Santvoort, Marc G. Besselink, Erik G. von Asmuth, Maarten S. van Leeuwen, et al. "Safety of radiofrequency ablation in patients with locally advanced, unresectable pancreatic cancer: A phase II study." European Journal of Surgical Oncology 45, no. 11 (November 2019): 2166–72. http://dx.doi.org/10.1016/j.ejso.2019.06.008.

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