4.7 Article

Improving quality of life in pancreatic cancer patients following high-intensity focused ultrasound (HIFU) in two European centers

Journal

EUROPEAN RADIOLOGY
Volume 31, Issue 8, Pages 5818-5829

Publisher

SPRINGER
DOI: 10.1007/s00330-020-07682-z

Keywords

Pancreatic neoplasms; High-intensity focused ultrasound ablation; Palliative care; Pain management; Quality of life

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This study evaluated the impact of HIFU on the quality of life of patients with advanced pancreatic cancer. The results showed significant improvements in global health, physical functioning, emotional functioning, social functioning, pain, fatigue, and appetite loss after HIFU treatment. The study concluded that HIFU can effectively improve QOL and physical symptoms with minimal side effects, making it a valuable additional treatment option for advanced pancreatic cancer.
Objectives Pancreatic cancer patients often have a high symptom burden, significantly impairing patients' quality of life (QOL). Nevertheless, there are hardly any reports on the impact of high-intensity focused ultrasound (HIFU) on the QOL of treated patients. For the first time, this study evaluated the effect of HIFU on QOL and compared these results in two European centers. Methods Eighty patients with advanced pancreatic cancer underwent HIFU (50 in Germany, 30 in Bulgaria). Clinical assessment included evaluation of QOL and symptoms using the EORTC QLQ-C30 questionnaire at baseline and 1, 3, and 6 months after HIFU. Pain intensity was additionally evaluated with the numerical rating score (NRS). Results Compared to baseline, global health significantly improved 3 and 6 months after HIFU treatment (p = 0.02). Functional subscales including physical, emotional, and social functioning were considerably improved at 6 months (p = 0.02, p = 0.01, and p = 0.01, respectively) as were leading symptom pain (p = 0.04 at 6 months), fatigue (p = 0.03 at 3 and p = 0.01 at 6 months), and appetite loss (p = 0.01 at 6 months). Moreover, pain intensity measured by NRS revealed effective and strong pain relief at all time points (p < 0.001). Reported effects were independent of tumor stage, metastatic status, and country of treatment. Conclusions This study showed that HIFU represents an effective treatment option of advanced pancreatic cancer improving QOL by increasing global health and mitigation of physical complaints with a low rate of side effects, independent of the examiner. Therefore, HIFU is a worthwhile additional treatment besides systemic palliative chemotherapy or best supportive care in management of this aggressive disease.

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