Ultrasound-guided high-intensity focused ultrasound for pancreatic cancer: Follow-up and clinical analysis

Objective: To evaluate the efficacy and safety of high-intensity focused ultrasound ablation in the treatment of pancreatic cancer and to analyze relevant prognostic factors.

Methods: A retrospective analysis was conducted on 68 patients with pancreatic cancer who underwent high-intensity focused ultrasound treatment. Ablation effects and adverse reactions related to HIFU were evaluated after the procedure. The Kaplan-Meier method was used for survival analysis. Univariate analysis of prognostic factors was performed using the log-rank test, and multivariate analysis was conducted using the COX regression model.

Results: The adverse events related to HIFU were mostly mild to moderate (CTCAE grades 1–2), with no severe adverse events (CTCAE grades 4–5) observed. The overall tumor response rate was 54.4%, and the disease control rate was 88.3%. The median progression-free survival was 4 months. The 6-month, 1-year, and 2-year progression-free survival rates were 36.8%, 11.8%, and 1.5%. The median overall survival was 13.1 months, with 6-month, 1-year, and 2-year overall survival rates of 81.0%, 62.3%, and 15.2%, respectively.Univariate analysis of prognostic factors of PFS showed that tumor location, tumor size of the pancreas, T stage, N stage, M stage, TNM staging, vascular invasion, liver metastasis, extrahepatic metastasis, tumor response, and combination therapy had significant difference (P < 0.05). Multivariate analysis showed that TNM stage, liver metastasis, extrahepatic metastasis, tumor response, and combination therapy were independent prognostic factors for PFS (P < 0.05).Multivariate analysis of risk factors influencing OS showed that TNM stage, liver metastases, extrahepatic metastases, prior antitumor therapy, HIFU sessions and combination therapy were independent prognostic factors (P < 0.05).

Conclusion: High-Intensity focused ultrasound demonstrates favorable safety and efficacy in the treatment of pancreatic cancer. Liver metastases, extrahepatic metastases, TNM staging, combination therapy, prior antitumor treatment, tumor response, and HIFU sessions were identified as independent prognostic factors. Among these, combination therapy and repeated HIFU sessions were protective prognostic factors.

Keywords: High-intensity focused ultrasound; pancreatic cancer; prognostic factors; safety; efficacy.