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

Milka Marinova; Hyuliya Feradova; Maria A Gonzalez-Carmona; Rupert Conrad; Tolga Tonguc; Marcus Thudium; Marc U Becher; Zhou Kun; Grigor Gorchev; Slavcho Tomov; Christian P Strassburg; Ulrike Attenberger; Hans H Schild; Dobromir Dimitrov; Holger M Strunk

doi:10.1007/s00330-020-07682-z

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

Eur Radiol. 2021 Aug;31(8):5818-5829. doi: 10.1007/s00330-020-07682-z. Epub 2021 Jan 23.

Authors

Affiliations

¹ Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany.
² HIFU Center, University St. Marina Hospital, Medical University-Pleven, Pleven, Bulgaria.
³ Clinic for Internal Medicine I, University Hospital Bonn, Bonn, Germany.
⁴ Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.
⁵ Department of Anaesthesiology, University Hospital Bonn, Bonn, Germany.
⁶ Clinic for Internal Medicine II, University Hospital Bonn, Bonn, Germany.
⁷ Clinical Center for Tumor Therapy, 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁸ Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany. strunk@uni-bonn.de.

^# Contributed equally.

PMID: 33486605
DOI: 10.1007/s00330-020-07682-z

Abstract

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.

Key points: • In a prospective two-center study, it was shown that HIFU represents an effective treatment option of advanced pancreatic cancer improving QOL. • HIFU in pancreatic cancer patients is associated with a low rate of side effects, independent of the performer. • HIFU is a worthwhile additional treatment besides systemic palliative chemotherapy or best supportive care in management of this aggressive disease.

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

MeSH terms

Germany
High-Intensity Focused Ultrasound Ablation*
Humans
Pancreatic Neoplasms* / therapy
Prospective Studies
Quality of Life