High-intensity focused ultrasound in patients with late-stage pancreatic carcinoma.

Objectives: To observe the efficacy of high intensity focused ultrasound (HIFU) in the treatment of late-stage pancreatic carcinoma and evaluate its influence on cell-mediated immunity in the host.

Methods: Fifteen patients with late-stage pancreatic carcinoma had their tumor tissue completely destroyed with HIFU. Evaluation of efficacy was made on the basis of clinical symptom changes, variations in tumor echo, changes in pancreatic amylase, serum CA19-9 and CA242, CD3(+), CD4(+) subsets, CD4(+)/CD8(+) ratios and NK cell activity.

Results: Clinical symptoms such as pain were significantly alleviated, echo of tumor was enhanced with B-US, CA19-9 and CA242 were decreased and pancreatic amylase showed no change. Eating, sleeping and mental status were all markedly improved; no serious complications were seen. On the other hand, NK cell activity was significantly enhanced in 10 patients (P < 0.05), and CD3(+) and CD4(+) subsets as well as CD4(+)/CD8(+) ratios increased to different degrees.

Conclusions: The use of HIFU in the treatment of late-stage pancreatic carcinoma is feasible and safe. It is effective in destroying the carcinoma and alleviating abdominal pain; it may enhance cell-mediated immunity in the host. This technique may offer a noninvasive therapy for the treatment of late-stage pancreatic carcinoma.