Successful application of radiofrequency ablation for malignant neoplasms of the pancreas

A distinctive feature of pancreatic cancer is its aggressiveness and rapidity. Neuroendocrine tumors are distinguished among neoplasms of the pancreas. Pancreatic neuroendocrine tumors are diagnosed on the basis of anamnesis, laboratory tests and the results of instrumental studies. However, the non-specific character of symptoms does not allow early detection of the disease. In a large proportion of patients, pancreatic neoplasms are diagnosed at stages III-IV. Radiofrequency ablation is an invasive intervention with the high temperature local effect on the tumor, resulting in the death of neoplastic cells. The method is based on the effect of high-frequency radio waves on pathological tissues. 6 radiofrequency ablations of neuroendocrine tumors of the pancreas under the control of endoscopic ultrasonography were performed at the N. N. Blokhin Oncology Research Center. There were no complications in the postoperative period. All patients were discharged with recommendations for supervision of an oncologist at their place of residence. It is also noted that such a method of treatment improves the further course of the disease and the life quality in patients.

radiofrequency ablation, neuroendocrine pancreatic tumors, pancreatic formations, endosonography, EUS, pancreatic cancer

1. Moskvicheva L.I., Petrov L. O., Sidorov D. V. The possibilities of modern methods of ablation in non-resectable locally advanced pancreatic cancer. Research and Practical Medicine Journal. 2018;5(2):86-99. (In Russ.) doi: 10.17709/2409-2231-2018-5-2-10.@@ Москвичева Л. И., Петров Л. О., Сидоров Д. В. Возможности современных методов абляции при нерезектабельном местно-распространенном раке поджелудочной железы. Research’n practical medicine journal. 2018;5(2):86-99. doi: 10.17709/2409-2231-2018-5-2-10.

2. Karpov O.E., Vetshev P. S., Bruslik S. V., Sviridova T. I., Levchuk A. L., Sarzhevskiy V. O., Sudilovskaya V. V. Ultrasound Ablation (HIFU) in the Treatment of Pancreatic Unresectable Tumors. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2015;20(3):17-23. (In Russ.) doi: 10.16931/1995-5464.2015317-23.@@ Карпов О. Э., Ветшев П. С., Бруслик С. В., Свиридова Т. И., Левчук А. Л., Саржевский В. О., Судиловская В. В. Ультразвуковая абляция (hifu) в лечении нерезектабельных опухолей поджелудочной железы. Анналы хирургической гепатологии. 2015;20(3):17-23. doi: 10.16931/1995-5464. 2015317-23.

3. Yashin S.S., Melikdzhanyan M. V., Semenaya E. V., Kozlov G. N., Kraynikova E. A. PANCREATIC CANCER: REVIEW AND CLINICAL CASE. Astrakhan medical journal. 2022;17(3):84-91. (In Russ.) doi: 10.48612/agmu/2022.17.3.84.91.@@ Яшин C. C., Меликджанян М. В., Семеная Е. В., Козлов Г. Н., Крайникова Е. А. Рак поджелудочной железы: обзор литературы и описание клинического случая. Астраханский медицинский журнал. 2022;17(3):84-91. doi: 10.48612/agmu/2022.17.3.84.91.

4. Morgoshiia T. S. Neuroendocrine tumors of the pancreas: from theory to practical recommendations. Pediatrician (St. Petersburg). 2018;9(1):90-99. (in Russ.) doi: 10.17816/PED9190-99.@@ Моргошия Т. Ш. Нейроэндокринные опухоли поджелудочной железы: от теории к практическим рекомендациям. педиатр. 2018. Т. 9. № 1. С. 90-99. doi: 10.17816/ped9190-99.

5. Rustagi T., Chhoda A. Endoscopic radiofrequency ablation of the pancreas. Dig dis sci. 2017 apr;62(4):843-850. doi: 10.1007/s10620-017-4452-y.

6. Patyutko Yu.I., Podluzhny D. V., Kotelnikov A. G., Sagaidak I. V. Cryosurgical method in the treatment of patients with malignant tumors of the pancreas. Ramn, surgical department of liver and pancreas tumors. 2005. (in Russ.)@@ Патютко Ю. И., Подлужный Д. В., Котельников А. Г., Сагайдак И. В. Криохирургический метод в лечении больных злокачественными опухолями поджелудочной железы. Рамн, хирургическое отделение опухолей печени и поджелудочной железы. 2005 г.

7. Ahmed M., Solbiati L., Brace C. L., Breen D. J., et al; International Working Group on Image-Guided Tumor Ablation; Interventional Oncology Sans Frontières Expert Panel; Technology Assessment Committee of the Society of Interventional Radiology; Standard of Practice Committee of the Cardiovascular and Interventional Radiological Society of Europe. Image-guided tumor ablation: standardization of terminology and reporting criteria - a 10-year update. J Vasc Interv Radiol. 2014 Nov;25(11):1691-705.e4. doi: 10.1016/j.jvir.2014.08.027.

8. Zhou Y. High-intensity focused ultrasound treatment for advanced pancreatic cancer. Gastroenterol Res Pract. 2014;2014:205325. doi: 10.1155/2014/205325.

9. Lin M., Liang S., Wang X., Liang Y., Zhang M., Chen J., Niu L., Xu K. Percutaneous irreversible electroporation combined with allogeneic natural killer cell immunotherapy for patients with unresectable (stage III/IV) pancreatic cancer: a promising treatment. J Cancer Res Clin Oncol. 2017 Dec;143(12):2607-2618. doi: 10.1007/s00432-017-2513-4.

10. Dagoglu N., Callery M., Moser J., Tseng J., Kent T., Bullock A., Miksad R., Mancias J. D., Mahadevan A. Stereotactic Body Radiotherapy (SBRT) Reirradiation for Recurrent Pancreas Cancer. J Cancer. 2016 Jan 10;7(3):283-8. doi: 10.7150/jca.13295.

11. Paiella S., Salvia R., Girelli R., Frigerio I., Giardino A., D’onofrio m, et al. Role of local ablative techniques (radiofrequency ablation and irreversible electroporation) in the treatment of pancreatic cancer. Updates surg. 2016 sep;68(3):307-311. doi: 10.1007/s13304-016-0385-9.

12. Rustagi T., Chhoda A. Endoscopic radiofrequency ablation of the pancreas. Dig dis sci. 2017 apr;62(4):843-850. doi: 10.1007/s10620-017-4452-y.

13. Wu f. High intensity focused ultrasound: a noninvasive therapy for locally advanced pancreatic cancer. World j gastroenterol. 2014 nov 28;20(44):16480-8. doi: 10.3748/wjg.v20.i44.16480.

14. Chang K. J. State of the art lecture: endoscopic ultrasound (eus) and fna in pancreatico-biliary tumors. Endoscopy. 2006; 38 (suppl. 1): 556-60.

15. Clinical recommendations - pancreatic cancer - 2021-2022-2023 (04.06.2021) - approved by the Ministry of Health of the Russian Federation (in Russ.)@@ Клинические рекомендации - рак поджелудочной железы - 2021-2022-2023 (04.06.2021) - утверждены минздравом рф. http://disuria.ru/_ld/10/1032_kr21c25mz.pdf

16. Nikulin M.P., Selchuk V. Yu., Chistyakov S. S., Ibragimov T. F., Titova G. V. Pancreas cancer. Rmzh. 2006;24:1726. (in Russ.)@@ Никулин М. П., Сельчук В. Ю., Чистяков С. С., Ибрагимов Т. Ф., Титова Г. В. Рак поджелудочной железы. Рмж. 2006;24:1726.