Repeated high‑intensity focused ultrasound combined with iodine‑125 seed interstitial brachytherapy offers improved quality of life and pain control for patients with advanced pancreatic cancer: A 52‑patient retrospective study

Liu,Yumei; Ji,Yongshuo; Zhu,Junqiu; Zhu,Linglin; Zhu,Yanfei; Bao,Zhijun; Zhao,Hong

doi:10.3892/ol.2024.14290

Repeated high‑intensity focused ultrasound combined with iodine‑125 seed interstitial brachytherapy offers improved quality of life and pain control for patients with advanced pancreatic cancer: A 52‑patient retrospective study

Authors:
- Yumei Liu
- Yongshuo Ji
- Junqiu Zhu
- Linglin Zhu
- Yanfei Zhu
- Zhijun Bao
- Hong Zhao
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Affiliations: High‑Intensity Focused Ultrasound Center of Oncology Department, Huadong Hospital Affiliated to Fudan University, Shanghai 200000, P.R. China, Department of Gerontology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, P.R. China
Published online on: February 16, 2024 https://doi.org/10.3892/ol.2024.14290
Article Number: 157
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Patients diagnosed with pancreatic cancer who have 5‑year survival rates of ~5% are typically in the advanced stage. Pancreatic cancer has become the third leading cause of cancer‑related death in the United States and there is still a lack of effective treatments to improve patient survival rate. Hence, the purpose of the present retrospective study was to assess the potential clinical impact of repeated high‑intensity focused ultrasound (HIFU) combined with iodine‑125 (¹²⁵I) interstitial brachytherapy for the treatment of patients with advanced pancreatic cancer who were ineligible for or declined surgery and chemotherapy. A total of 52 patients diagnosed with advanced pancreatic cancer were included in the study. At least one course of HIFU therapy combined with percutaneous ultrasound‑guided ^₁₂₅I seed implantation was administered to each patient. The clinical assessment included an evaluation of Karnofsky Performance Scale (KPS) score at baseline, and at 1 and 2 months after combined therapy. Pain intensity was additionally evaluated with the numerical rating score (NRS). Overall survival (OS) times and survival rates at 3, 6, 9 and 12 months after combined treatment were evaluated. Adverse events commonly associated with HIFU and ¹²⁵I seed implantation were recorded, and the severity of adverse events was graded according to the Common Terminology Criteria for Adverse Events, version 4. All 52 patients received successful repeated HIFU treatment combined with ¹²⁵I seed implantation and were included in the analysis of efficacy and safety. The median OS time of patients was estimated to be 13.1 months (95% CI, 11.3‑14.8). The survival rates at 3, 6, 9 and 12 months were 100.0, 86.5, 61.5 and 53.8%, respectively. The mean KPS score was 62.7±6.3 at baseline, 73.7±7.9 at 1 month and 68.8±6.5 at 2 months after combined treatment. KPS score increased significantly after combined therapy. The mean NRS score was 6.7±1.6 at baseline, and 4.7±1.7 and 5.4±1.5 at 1 and 2 months after combined treatment, respectively. The number of patients with severe pain and the NRS score were both significantly lower at 1 and 2 months after ¹²⁵I seed implantation compared with those at baseline. No serious complications were detected during the follow‑up period. In conclusion, the present study demonstrated the survival benefit and improvement in quality of life of patients with advanced pancreatic cancer receiving repeated HIFU treatment combined with ¹²⁵I interstitial brachytherapy, which may provide new ideas and methods for the treatment of pancreatic cancer.

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