pISSN 2636-0004eISSN 2636-0012
pISSN 2636-0004Published Data of EUS Guided RFA Treatments in Pancreatic Disease
| Reference | Author | No. patients | RFA devices | Mean tumor size (mm) | Settings | Efficacy | Overall survival ( |
RFA related adverse events ( |
Prophylaxis |
|---|---|---|---|---|---|---|---|---|---|
| Pancreatic neuroendocrine neoplasm | Lakhtakia et al15 | 3 insulinomas | EUSRA | 14–22 | 50 W | Symptoms relief (100%), persistent at 11 mo FU | All patients alive at 11 mo FU | 0 | NA |
| Choi et al14 | 7 NF-NENs, 1 insulinoma | EUSRA | 20 (8–28) | 50 W (10 sec) | 6 complete responses, 2 incomplete responses; remission of hypoglycemic symptoms in insulinoma patient | 2 (25%): 1 abdominal pain, 1 pancreatitis | Broad-spectrum antibiotics | ||
| Oleinikov et al16 | 7 insulinomas, 11NF-NENs (some multifocal; 2 with treatable metastasis); 27 total lesions | EUSRA | 14.4 (4.5–30) | 10–50 W, 5–12 sec | 26/27 lesions with typical post-ablative changes at CE-EUS; 7 (100%) symptoms resolution in insulinomas; no recurrence after mean 8.7 mo FU | 2 (11%) mild pancreatitis | Broad-spectrum antibiotics | ||
| Barthet et al11 | 14 NF-NENs (Grade 1) | EUSRA | 12 (10–20) | 50 W until bubbles or impedance 100–500 Ω | 12 (86%) complete disappearance; 2 absence of Doppler at EUS | NA | 2 (14%): 1 acute necrotizing pancreatitis (RF without suction of cystic fluid), 1 MPD stenosis; 20% postprocedural pain | After the first 2 patients: rectal NSAIDs + amoxicillin/clavulanate | |
| Pancreatic ductal adenocarcinoma | Wang et al21 | 3 LAPC | Habib | 37.3 | 10–15 W, 2 min | Mean reduction in tumor size: 13.94% | NA | 0 | NA |
| Song et al20 | 4 LAPC + 2 MPC | EUSRA | 38 (30–90) | 20–50 W, 10 sec | NA | 2 (33%) self-limiting pain | Broad-spectrum antibiotics | ||
| Scopelliti et al19 | 10 LAPC | EUSRA | 25–75 | 20 W (lesion < 3 cm), 30 W until impedeance 500 Ω | Mean diameter of necrosis at 30 day CT: 30 ± 13 mm | NA | 4 (40%): 2 postprocedural self limiting pain, 2 asymptomatic ascite | Broad-spectrum antibiotics + octreotide + LMWH | |
| Crinò et al18 | 8 LAPC + 1 metastatic rectal cancer | EUSRA | 36 (22–67) | 30 W | Ablated area in all patients at 30 day CT: mean diameter 3.75 cm3 (0.72–12.6 cm3), 30% of tumor mass | NA | 3 (33%): 3 mild abdominal pain | NA | |
| Yang and Zhang22 | 8 unresectable pancreatic cancer | Habib | NA | NA | Ablated area inside the tumor in 100% | 8.3 mo | 0 | NA | |
| Arcidiacono et al17 | 22 LAPC | HybridTherm | 335.7 (23–54) | 18 W, cooling pressure 650 psi. | 6 mo (13 patients) | 8 (50%): 3 mild postprocedural pain, 1 duodenal bleeding; 1 hemobilia and jaundice†, 1 jaundice†, 1 duodenal stricture†, 1 peripancreatic fluid collection | Ceftriaxone + gabexate mesylate | ||
| Pancreatic cystic lesiosns | Pai et al23 | 4 MCN, 1 IPMN, 1 microcystic adenoma | Habib | 36.5 (20–70) | 5–25 W, 90-120 sec | 2 complete resolution; 4 reduction (mean: 50%) | NA | 2 (33%): self-limiting pain | Cyst aspiration before RFA |
| Barthet et al11 | 16 IPMN, 1 MCN | EUSRA | 28 (9–60) | 50 W until bubbles or impedance 100–500 Ω | 12 (70.6%) significant response: 11 disappearance and 1 > 50% decrease; 12/12 (100%) disappearance of mural nodules | NA | 1 (6%): 1 perforation of jejunal loop (RF without suction of cystic fluid); 20% postprocedural pain | After the first patient, aspiration of the cyst before RF |
EUS, endoscopic ultrasound; RFA, Radiofrequency ablation; FU, follow-up; NF-NEN, non-functioning neuroendocrine neoplasms; CE-EUS, contrast enhanced EUS; MPD, main pancreatic duct; NSAIDs, non-steroidal anti-inflammatory drugs; LAPC, locally advanced pancreatic cancer; MPC, metastatic pancreatic cancer; CT, computed tomography; LMWH, low-molecular-weight heparin; MCN, mucinous cystic neoplasm; IPMN, intraductal papillary mucinous neoplasm.
Values are presented as median (range) or mean only.