Contrast-enhanced harmonic endoscopic ultrasonography for evaluating the response to chemotherapy in pancreatic cancer

Dig Liver Dis. 2019 Aug;51(8):1130-1134. doi: 10.1016/j.dld.2019.03.015. Epub 2019 Apr 19.

Abstract

Background and aims: Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) is used for the diagnosis of pancreatic cancer (PC). Here, we examined the usefulness of CH-EUS for evaluating therapeutic responses in PC.

Methods: The study included 23 patients with PC who received chemotherapy. Patients underwent contrast-enhanced computed tomography (CE-CT) and CH-EUS before chemotherapy and at the time of evaluation of the therapeutic response. Patients with a ≧50% reduction in serum carbohydrate antigen 19-9 levels after chemotherapy were defined as "super responders". The incidence of an avascular area in the tumor on CH-EUS after chemotherapy was compared between "super responders" and non-super responders.

Results: Nine patients were included in the "super responders" group.Tumor reduction rates did not differ significantly between CE-CT and CH-EUS in the "super responders". The appearance of an avascular area was detected in 7 of 9 super responders (77.8%) and in 4 of 14 non-super responders (28.6%), and the difference was significant (P = 0.036). The mean survival time of patients with an avascular area after chemotherapy was longer than that of without an avascular area.

Conclusions: Detection of avascular areas by CH-EUS after chemotherapy may predict long-term survival of patients with PC.

Keywords: Chemotherapy; Contrast-enhanced harmonic endoscopic ultrasonography; Endoscopic ultrasonography; Pancreatic cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • CA-19-9 Antigen / blood
  • Endosonography*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Pancreas / diagnostic imaging*
  • Pancreas / pathology
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Neoplasms / pathology
  • Prognosis
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • CA-19-9 Antigen