Background and Aims

EUS has become an interventional technique 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 stage IIb-III pancreatic cancer underwent EUS-guided LA. All patients were unresponsive to previous chemoradiotherapy. LA was performed by using a 300-μm flexible fiber preloaded onto a 22-gauge fine needle. A 1064-nm wavelength neodymium-yttrium aluminum garnet (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 1 of these settings. The application time of the power settings ranged from 200 to 600 seconds.

Results

Nine patients (median age, 74.7; range 55-85) underwent Nd:Yag LA. The mean size of the focal lesion was 35.4 mm (range, 21-45). The ablation area, demonstrated by 24-hour CT, ranged from .4 cm³ (for the lower power setting of 2 W/800 J) to a maximum of 6.4 cm³ (for 4 W/1000 J). The procedure 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.

中文翻译：

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EUS引导的Nd：YAG激光切除不可切除的胰腺腺癌的可行性

背景和目标

EUS已成为一种介入技术，其中可以将针用作输送治疗剂的媒介。激光消融（LA）已用于治疗许多原发性和继发性肿瘤。这项研究旨在评估EUS指导的LA治疗不可切除（UR）胰腺癌的可行性。

方法

IIb-III期胰腺癌患者接受EUS指导的LA。所有患者对先前的放化疗均无反应。通过使用预装在22号细针上的300μm柔性纤维进行LA。波长为1064nm的钕钇铝石榴石（Nd：YAG）激光，在800 J，1000 J和1200 J的功率设置下为2 W；800 W，1000 J和1200 J时为3 W; 对于800 J，1000 J和1200 J使用4W。每位患者仅接受其中一种设置的治疗。电源设置的应用时间范围为200到600秒。

结果

9名患者（中位年龄为74.7；范围为55-85）接受了Nd：Yag LA治疗。局灶性病变的平均大小为35.4毫米（范围21-45）。通过24小时CT显示的消融面积范围为.4 cm ³（对于2 W / 800 J的较低功率设置）到最大6.4 cm ³（对于4 W / 1000 J的功率）。所有9例患者均完成了手术，无不良事件。

结论

根据我们的经验，EUS指导的LA在UR胰腺癌患者中是可行的且耐受性良好。