Treatment of human pancreatic cancer using combined ultrasound, microbubbles, and gemcitabine: A clinical case study

• Published in: Medical physics (Lancaster) 2013-07, Vol.40 (7), p.072902-n/a
• Main Authors: Kotopoulis, Spiros, Dimcevski, Georg, Helge Gilja, Odd, Hoem, Dag, Postema, Michiel
• Format: Article
• Language: English
• Subjects: Aged; biomedical ultrasonics; Cancer; chemotherapy; Combined Modality Therapy; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Diagnosis using ultrasonic, sonic or infrasonic waves; Disease Progression; Female; Fluid bubbles; Humans; Image scanners; Life Sciences; Male; Medical imaging; Medical Physics; microbubbles; Microbubbles - therapeutic use; Middle Aged; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - therapy; Physics; Radiation treatment; Shock wave effects; sonoporation; Therapeutics; Tissues; tumours; Ultrasonic Therapy; Ultrasonography; ultrasound
• ISSN: 0094-2405; 2473-4209
• DOI: 10.1118/1.4808149

Purpose: The purpose of this study was to investigate the ability and efficacy of inducing sonoporation in a clinical setting, using commercially available technology, to increase the patients’ quality of life and extend the low Eastern Cooperative Oncology Group performance grade; as a result increasing the overall survival in patients with pancreatic adenocarcinoma. Methods: Patients were treated using a customized configuration of a commercial clinical ultrasound scanner over a time period of 31.5 min following standard chemotherapy treatment with gemcitabine. SonoVue® ultrasound contrast agent was injected intravascularly during the treatment with the aim to induce sonoporation. Results: Using the authors’ custom acoustic settings, the authors’ patients were able to undergo an increased number of treatment cycles; from an average of 9 cycles, to an average of 16 cycles when comparing to a historical control group of 80 patients. In two out of five patients treated, the maximum tumor diameter was temporally decreased to 80 ± 5% and permanently to 70 ± 5% of their original size, while the other patients showed reduced growth. The authors also explain and characterize the settings and acoustic output obtained from a commercial clinical scanner used for combined ultrasound microbubble and chemotherapy treatment. Conclusions: It is possible to combine ultrasound, microbubbles, and chemotherapy in a clinical setting using commercially available clinical ultrasound scanners to increase the number of treatment cycles, prolonging the quality of life in patients with pancreatic adenocarcinoma compared to chemotherapy alone.