Systematic review of novel ablative methods in locally advanced pancreatic cancer

Table 6 Studies of high intensity focused ultrasound in pancreatic ductal adenocarcinoma

Study	n	Study	Outcome and survival	Complications
Wang et al[59] (non-English article)	15	HIFU monotherapy in late stage PDAC	Pain relief: 13/13 (100%)	Mild abdominal pain (2/15)
Xie et al[60] (non-English article)	41	HIFU alone vs HIFU + gemcitabine in locally advanced PDAC	Pain relief: HIFU (66.7%),	None
			HIFU + gemcitabine (76.6%)
Xu et al[61] (non-English article)	37	HIFU monotherapy in advanced PDAC	Pain relief: 24/30 (80%)	None
Yuan et al[62] (non-English article)	40	HIFU monotherapy	Pain relief: 32/40 (80%)	None
Wu et al[63]	8	HIFU in advanced PDAC	Median survival: 11.25 mo	None
			Pain relief: 8/8
Xiong et al[64]	89	HIFU in unresectable PDAC	Median survival: 26.0 mo (stage II), 11.2 mo (stage III) and 5.4 mo (stage IV)	Superficial skin burns (3.4%), subcutaneous fat sclerosis (6.7%), asymptomatic pseudocyst (1.1%)
Zhao et al[65]	37	Phase II study of gemcitabine + HIFU in locally advanced PDAC	Overall survival: 12.6 mo (95%CI: 10.2-15.0 mo) Pain relief: 78.6%	16.2% experienced grade 3 or 4 neutropenia, 5.4% developed grade 3 thrombocytopenia, 8% had nausea vomiting
Orsi et al[66]	6	HIFU in unresectable PDAC	Pain relief: 6/6 (100%)	Portal vein thrombosis (1/6)
Sung et al[67]	46	Stage III or IV PDAC	Median survival: 12.4 mo. Overall survival at 12 mo was 30.4%	Minor complications (abdominal pain, fever and nausea): 57.1% (28/29) Major complications (pancreaticoduodenal fistula, gastric ulcer or skin burns): 10.2% (5/49)
Wang et al[68]	40	Advanced PDAC	Median overall survival: 10 mo (stage III) and 6 mo (stage IV). Pain relief: 35/40 (87.5%)	None
Lee et al[69]	12	HIFU monotherapy in unresectable PDAC (3/12 received chemotherapy)	Median overall survival for those receiving HIFU alone (9/12 patients): 10.3 mo	Pancreatitis: 1/12
Li et al[70]	25	Unresectable PDAC	Median overall survival: 10 mo. 42% survived more than 1 year. Performance status and pain levels improved: 23/25	1st degree skin burn: 12% Mortality: 0%
Wang et al[71]	224	Advanced PDAC	Not reported	Abdominal distension, anorexia and nausea: 10/ 224 (4.5%). Asymptomatic vertebral injury: 2/224
Gao et al[72]	39	Locally advanced PDAC	Pain relief: 79.5% Median overall survival: 11 mo. 30.8% survived more than one year	None

HIFU: High intensity focused ultrasound; PDAC: Pancreatic ductal adenocarcinoma.