In patients with pancreatic cancer (PC), who cannot undergo surgery for one or another reason, the efficiency of treatment is currently very limited, which contributes to the search for and application of new techniques.

OBJECTIVE

To evaluate the safety and efficiency of a combination of gemcitabine monochemotherapy (MCT) and high-intensity focused ultrasound (HIFU) therapy in patients with pancreatic cancer versus as first-line FOLFIRINOX palliative chemotherapy (PCT).

SUBJECTS AND METHODS

The present study involved 2 patient groups: a study group of 35 patients with Stage II-IV PC and ECOG performance status scores of 0-2, who received combination treatment (MTC with gemcitabine and HIFU therapy) and a control group of 35 patients with Stage II-IV PC and an ECOG score of 0-1, who had first-line FOLFIRINOX PCT performed on a device operating with an ultrasonic wave intensity of 2 kW/cm2.

RESULTS

The maximum objective response rate of the tumor process and that of the primary tumor were observed at 6 months of treatment and amounted to 14.3 and 22.9%, respectively. By this time, there was a reduction in the severity of pain syndrome in 58.3% of patients; the pain control rate was as much as 95.8%. The median overall life expectancy in the study and control groups was 16 and 14 months (p=0.016), the median progression-free life expectancy was 9 and 7 months (p=0.049); the 1-, 2- and 3-year overall survival rates were 71.4 and 60% (p=0.416), 17.1 and 0% (p=0.016), and 5.7 and 0% (p=0.016), respectively. In the study and control groups, grades 3—4 toxic reactions were noted in 25.7 and 57.1% of patients, respectively (p=0.0146). The side effects of HIFU therapy were found in 34.3% of patients.

CONCLUSION

The combination of MCT with gemcitabine and HIFU therapy may be recommended for PC patients; for whom surgical treatment or combination chemotherapy regimens, are not indicated.