Endoscopic ultrasound guided radiofrequency ablation for the treatment of advanced pancreatic cancer / 中华胰腺病杂志

ABSTRACT

Objective To investigate the feasibility,safety,and short term efficacy of endoscopicultrasound guided radiofrequency ablation (EUS-RFA).Methods Three patients with advanced,inoperable pancreatic carcinoma underwent EUS-RFA.Under the guidance of EUS,a 22 gauge fine needle was punctured into the pancreatic carcinoma,and 1 Fr radiofrequency (RF) catheter was placed into the cancer through this 22 gauge needle.RFA was applied at 10 watts for 2 minutes,and then 15 watts for another 2 minutes.The second needle's tract was selected and punctured about 1 ～ 1.5 cm apart from the first needle tract,and the ablation was repeated.Results The average age of these 3 patients was 63 years old.Two patients were diagnosed to have pancreatic tail cancer and one was pancreatic body cancer,and the mean diameter of the tumor was 3.6 cm.Pre-operative EUS-FNA confirmed the presence of malignant cells.EUS-RFA was performed three times at an interval of 2 weeks in the first patient and one time in the last two patients.The average session of EUS-RFA of each lesion was 3.67 times.After 2 weeks,EUS showed that the diameter of the lesions was reduced by 13.9％ on average.There were vacuolar degenerations of variable sizes in those lesions.The serum level of CA19-9 was averagely decreased by 46.5％.Abdominal pain was not obviously aggravated.There were no episodes of pancreatitis,perforation or bleeding within 48 hours after the procedure.The mean follow-up time was 49 days,and no complications occurred.Conclusions EUS-RFA can reduce the diameter of pancreatic carcinoma and decrease the serum level of CA19-9,and it is feasible and safe.