Sequential high-intensity focused ultrasound treatment combined with chemotherapy for inoperable pancreatic cancer: a retrospective analysis for prognostic factors and survival outcomes

Shu Dong; Ailing Zhong; Huili Zhu; Kun Wang; Chien-shan Cheng; Zhiqiang Meng

doi:10.1080/02656736.2023.2278417

International Journal of Hyperthermia (Dec 2023)

Sequential high-intensity focused ultrasound treatment combined with chemotherapy for inoperable pancreatic cancer: a retrospective analysis for prognostic factors and survival outcomes

Shu Dong,
Ailing Zhong,
Huili Zhu,
Kun Wang,
Chien-shan Cheng,
Zhiqiang Meng

Affiliations

Shu Dong: Minimally Invasive Therapy Center, Shanghai Cancer Center, Fudan University, Shanghai, China
Ailing Zhong: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Huili Zhu: Minimally Invasive Therapy Center, Shanghai Cancer Center, Fudan University, Shanghai, China
Kun Wang: Minimally Invasive Therapy Center, Shanghai Cancer Center, Fudan University, Shanghai, China
Chien-shan Cheng: Minimally Invasive Therapy Center, Shanghai Cancer Center, Fudan University, Shanghai, China
Zhiqiang Meng: Minimally Invasive Therapy Center, Shanghai Cancer Center, Fudan University, Shanghai, China

DOI: https://doi.org/10.1080/02656736.2023.2278417
Journal volume & issue: Vol. 40, no. 1

Abstract

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AbstractObjective To evaluate the effect of HIFU (High-Intensity Focused Ultrasound) therapy on the survival and prognosis of patients with inoperable pancreatic cancer, and the clinical application of serological prognostic indicators.Methods We retrospectively analyzed the clinicopathological features, laboratory tests and follow-ups of 192 patients. Among the patients, 57 were treated with HIFU prior to chemotherapy (HIFU-priority), and 135 patients received chemotherapy followed by HIFU (HIFU-second). Univariate and multivariate Cox regression analysis was used to determine the prognostic value of tumor inflammation-related serological markers. A nomogram model was established based on the identified prognostic factors.Results Univariate analysis showed that receiving the treatment regimen in HIFU-priority was a significant protective factor for overall survival (OS, p < 0.001). Tumor stage, high C-reactive protein (CRP), high gamma-glutamyl transferase(γGT) high carbohydrate antigen 125 (CA125), high neutrophil-to-lymphocyte ratio (NLR), high lymphocyte-to-monocyte ratio (LMR) and liver metastasis were significant risk factors for poor prognosis (p < 0.05). CRP combined with normal tumor marker CA125 (CRP + CA125) was associated with longer OS (p = 0.005). Multivariate analysis shows that HIFU-priority is a protective factor for OS (Hazard Ratio, HR: 0.38; 95% confidence interval(CI): 0.25-0.57), tumor stage (HR: 1.61; 95% CI: 1.12-2.31), CRP + CA125 (HR: 1.46; 95% CI: 1.02-2.08) and γGT (HR: 1.44; 95% CI: 1.04-1.98) are risk factors for OS and serve as independent prognostic factors in the nomogram.Conclusion Early application of HIFU treatment improves the OS of patients with inoperable pancreatic cancer. CRP + CA125 and γGT are independent prognostic factors.

Published in International Journal of Hyperthermia

ISSN: 0265-6736 (Print); 1464-5157 (Online)
Publisher: Taylor & Francis Group
Country of publisher: United Kingdom
LCC subjects: Medicine: Medicine (General): Medical technology
Website: https://www.tandfonline.com/journals/ihyt

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