Patient Chen is a 65 years old lady who was suffering from stomach pain for more than 4 months, with significant weight loss and pancreas mass was noted for 1 month, then went to see the doctor.
The patient was admitted to the local hospital three months ago due to the dull pain in the upper abdomen, but the blood amylase was slightly higher, and no remission was found after the treatment of pancreatitis. Further CT examination revealed mass in the pancreatic body and tail, which was considered pancreatic cancer. PET-CT examination revealed a high uptake mass in the pancreatic body and tail, which was considered as pancreatic cancer. Tumor marker: CA199 (458U/ml). She was initially diagnosed as stage III AJCC (T4N1M0).
Preoperative enhanced CT showed pancreatic neoplasm
According to the preoperative evaluation of the patient, the patient has no opportunity for radical surgery. Currently, the conventional treatment is mainly chemotherapy, which can be combined with interventional therapy and radiotherapy. In order to seek more active treatment, the patient finally chose HIFU treatment.
During the treatment, real-time ultrasound images showed clear pancreatic tumor, and the tumor was treated by total coverage therapy.
The patient was in prone position during the treatment
The patient was treated with HIFU under sedation and analgesia for 90 minutes, irradiation for 399 seconds, average power of 283W, total energy of 113000 joules, and the patient has no special discomfort during the whole treatment process. Two hours after surgery, she could walk back home independently.
As HIFU focused ultrasound ablation was a local treatment, the patient was given chemotherapy for the residual cancer cells, using the modified FOLFIRINOX regimen and Xilonix. Three months later, the tumor marker CA199 was reduced to 171, and CT showed no tumor enlargement in the pancreas.
CT result of post-operative patient
Change of CA199
Till now, the survival time of the patient has enlarged into more than 20 months. The patient and her family are so happy to have a rebirth and will be more positive to live a better life.
HIFU is short for high-intensity focused ultrasound ablation and it represents the next generation of minimally invasive treatments for cancer.
HIFU utilizes ultrasound's good penetrability, and intensity as the ultrasound beam travels through the transducer probe and is focused into a point, precisely targeting the tumour, which is heated up between 60 to 100 Degrees Celsius. The cellular proteins of the tumour coagulate leading to tumour ablation (thermal destruction of tissue), without surrounding tissue being harmed. The dead tumour tissues are then gradually reabsorbed by the body.
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