Background and aims: Endoscopic ultrasound (EUS) has become an interventionaltechnique in which a needle may be used as a vehicle to deliver therapeutic agents. Laser ablation (LA) has been used to treat many primary and secondary neoplasms. This study aimed to assess the feasibility of EUS-guided LA for unresectable (UR) pancreatic cancer.Methods: Patients with a stage IIb-III pancreatic cancer underwent EUS-guided LA. All patients were unresponsive to previous chemo-radiotherapy. The laser ablation was performed by using a 300-μm flexible fiber preloaded on a 22-gauge fine needle. A 1064-nm wavelength Nd:YAG laser light with different power settings of 2 W for 800 J, 1000 J and 1200 J, 3 W for 800 J, 1000 J and 1200 J and 4 W for 800 J, 1000 J and 1200 J was used. Each patient was treated with a single application of one of these settings.The application time of the power settings ranged from 200s to 600s.Results: Nine patients (median age 74.7, range 55-85 years) underwent Nd:Yag LA. Themean size of the focal lesion was 35.4 mm (range 21-45 mm). The ablation areademonstrated by 24 hours computed tomography (CT)-scan, ranged from 0.4 cm3 (for thelower power setting of 2 W/800 J) to a maximum of 6.4 cm3 (for 4 W/1000 J). Theprocedure was completed in all 9 patients without adverse events.Conclusion: In our human experience EUS-guided LA was feasible and well tolerated in patients with UR pancreatic cancer

Feasibility of EUS-guided Nd:YAG laser ablation of unresectable pancreatic adenocarcinoma

Di Matteo FM;Pandolfi M;Schena E;Silvestri S;
2018-01-01

Abstract

Background and aims: Endoscopic ultrasound (EUS) has become an interventionaltechnique in which a needle may be used as a vehicle to deliver therapeutic agents. Laser ablation (LA) has been used to treat many primary and secondary neoplasms. This study aimed to assess the feasibility of EUS-guided LA for unresectable (UR) pancreatic cancer.Methods: Patients with a stage IIb-III pancreatic cancer underwent EUS-guided LA. All patients were unresponsive to previous chemo-radiotherapy. The laser ablation was performed by using a 300-μm flexible fiber preloaded on a 22-gauge fine needle. A 1064-nm wavelength Nd:YAG laser light with different power settings of 2 W for 800 J, 1000 J and 1200 J, 3 W for 800 J, 1000 J and 1200 J and 4 W for 800 J, 1000 J and 1200 J was used. Each patient was treated with a single application of one of these settings.The application time of the power settings ranged from 200s to 600s.Results: Nine patients (median age 74.7, range 55-85 years) underwent Nd:Yag LA. Themean size of the focal lesion was 35.4 mm (range 21-45 mm). The ablation areademonstrated by 24 hours computed tomography (CT)-scan, ranged from 0.4 cm3 (for thelower power setting of 2 W/800 J) to a maximum of 6.4 cm3 (for 4 W/1000 J). Theprocedure was completed in all 9 patients without adverse events.Conclusion: In our human experience EUS-guided LA was feasible and well tolerated in patients with UR pancreatic cancer
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12610/12808
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